Caring for an infant begins long before birth. Expectant moms are advised to avoid smoking and drinking, watch what they eat, and follow a host of other recommendations that are in the best interest of themselves and their little one on the way.
On top of offering sound advice, NYU Lutheran also provides pregnant women with important clinical information about their pregnancies — using the most advanced ultrasound technology to assess how their baby is developing inside the womb. Ultrasound technology uses high-frequency sound waves to detect invisible, anatomical flaws.
Shailini Singh, MD, site director of maternal fetal medicine (MFM) at NYU Lutheran, works closely with patients to get an early start on monitoring prenatal well-being of their unborn babies. Each soon-to-be mom seen by NYU Lutheran's MFM team is given a blood test and offered an ultrasound examination to measure for chromosomal problems and congenital heart defects.
Soon-to-be moms also undergo a more comprehensive ultrasound between 18 to 20 weeks to detect other possible fetal abnormalities that might develop during pregnancy. This test includes evaluation of a dozen different views of the developing heart. If an abnormality is detected, the patient is further evaluated by an NYU Lutheran pediatric cardiologist, who uses fetal echocardiography to confirm or rule out a heart defect.
In addition, certain conditions that the mother might have often prompt direct referrals to a pediatric cardiologist. These can include diabetes, hypertension, advanced maternal age, congenital abnormalities, family history of congenital heart defect, chromosomal abnormalities, and fetal arrhythmias.
"Early detection of a heart lesion allows us to provide neonates and their families with the available treatment options for the best possible outcome," said Achiau Ludomirsky, MD, professor of pediatrics and associate chair of the NYU Langone Medical Center Department of Pediatrics. "Using fetal echocardiography, we can diagnose any structural, functional, and rhythm abnormalities in the fetus."
NYU Lutheran, the central hub of NYU Langone Health System in Brooklyn, serves a large ethnic population in the Sunset Park area — and has recently introduced fetal echocardiography as part of an expansion of pediatric services that meets the needs of the growing community.
"The joint fetal-echo program is especially significant to our MFM unit because of a high prevalence of diabetes in our pregnant patient population," said Dr. Singh. "Poorly controlled diabetes increases the risk of congenital heart defects. These women typically receive pre-conception counseling to control diabetes, and are prescribed a regimen of folic acid at least three months prior to conception."
If neonatal cardiac abnormalities are confirmed, Dr. Singh and her MFM team at NYU Lutheran offer further tests to determine the level and degree of neonatal heart conditions, including amniocentesis (examination of fluid taken from the sac surrounding the developing fetus). "The frequency of fetal echoes depends on the type of defects. There are certain developmental anomalies of the heart that can become more severe as the pregnancy progresses," said Dr. Singh. "Our approach is a comprehensive one. We do not want to be blindsided by any undiagnosed birth defects."
A patient with a fetus suspected of significant congenital heart defects or other serious conditions are referred to the Hassenfeld Children's Hospital of New York at NYU Langone Medical Center in Manhattan or further evaluation and management.
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