Early Detection Gives Baby an Excellent Chance

Sometimes, the unexpected makes pregnancy even more uncertain. Kim Rasmussen was pregnant with her third child when a routine ultrasound showed a possible abnormality in the fetus’ heart. She recalls, "I was referred to the University of Chicago Medicine for a more in-depth scan."

After a level II ultrasound, cardiologists at the University of Chicago diagnosed Ebstein's Anomaly, a heart condition involving an abnormal tricuspid valve in the heart. The valve becomes enlarged, bulging into the heart’s right ventricle. "Bloodflow can be obstructed out to the pulmonary artery, there can be blood regurgitation, and blood may not flow into the lungs," explains Peter Koenig, MD, a pediatric cardiologist at Comer Children's Hospital at the University of Chicago.

During an echocardiogram of Rasmussen's baby, Dr. Koenig recognized the pulmonary valve opening and closing, signaling that the condition could be treated with medication and time, rather than with surgery. "We did extensive prenatal counseling with the parents and their obstetrician," says Brojendra Agarwala, MD, a Comer Children's Hospital pediatric cardiologist also involved with the case. "We agreed it would be best to deliver the baby close to the due date because his lungs would develop better in utero than if he were born early." Maternal-fetal medicine specialist Carolyn Zelop, MD, monitored the baby’s progress from 18 weeks through his birth.

At birth, the baby was put on prostaglandin therapy for several days and monitored in the neonatal intensive care unit at the Comer Children's Hospital. The pressure in his lungs consistently lowered. "He became more pink, which is a good sign that blood is flowing into the lungs," Dr. Koenig says.

"We took it for granted that I would have a normal pregnancy, birth, and baby." Rasmussen says. "Each time we visited the doctors, all the different possibilities for this baby were discussed. My husband and I wanted to give this baby the best chance to be healthy we could, so we decided to name him 'Chance.'"

Chance will have this heart condition for the rest of his life and will require regular visits to a cardiologist. But, "Chance is doing well, and there is every reason to believe he will continue to do so," says Dr. Agarwala.

December 2003


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