It is indeed difficult to deal with this topic. Not much is known about the various causes, for operating on a pregnant woman, in the first three months of pregnancy, during which period, development of the heart in the foetus is expected to be complete.
Under the above circumstances, the best thing would be that all pregnant mothers must undergo a routine ultrasonography, and if some abnormality is suspected, foetal echocardiography must be undertaken for the precise detection of congenital defect in the heart. However, the question of termination of pregnancy must be taken especially in consultation with a heart specialist, or one who is dealing with pediatric cardiac surgery. Many of the congenital lesions of the heart can be satisfactorily treated, though surgically. All aspects of the case must be studied like the number of children, and if the previous offspring have any congenital defect or not, or, if this pregnancy has occurred after a long period of time.
Heredity may play some role in the causation of the disease. If the mother has any congenital defect in her heart, the chances, though minimal, of a defect in the heart of the expected baby may increase. Genetic counselling may help in such cases before the pregnancy is planned.
There are some conditions worth mentioning which must be avoided by a pregnant mother, as there are some likely factors which may disturb the development of the heart in the foetus.
If the mother is diabetic, it must be properly controlled. Diabetes, and even prediabetes, is known to cause congenital defects in the heart. Similarly, if the mother is suffering from epilepsy, the teratogenic effect of antiepileptic drugs must be kept in mind. Therefore, in such cases foetal echocardiography is a must to assess the condition of the heart. Exposure to X rays/radiation should also be avoided.
All pregnant mothers, especially in the first three months of pregnancy, must be prevented from contracting any viral infection, particularly infection caused by the virus of German measles. A good diet is also essential during pregnancy, and in case the individual is taking alcohol, it must be stopped altogether. It may not only cause a congenital defect in the heart, it may also affect the general development of the foetus, especially the brain.
A drug like thalidomide, which is a known teratogenic, and one used in psychiatry, i.e. lithium, should also be stopped.
However, in spite of taking best possible precautions, the child may still be born with some congenital lesion in the heart. Therefore, as stated earlier; a routine ultrasonography and if need be, foetal echocardiography, is a must for all pregnant mothers in their first trimester. This will help them know the exact position of the heart of the foetus they are carrying and whether the pregnancy should be terminated, or continued, though there may be a little congenital lesion in the heart which can be treated/taken care of after the child is born.
It may be concluded that although prescribed precautions must be taken bya pregnant mother, yet detection of a lesion in the heart of the foetus during the period of pregnancy, or after the child is born, or during childhood (if the case has remained undetected earlier), as well as timely treatment/ surgery, will help a lot in improving the overall healthy span of life in such cases. And for all this, a mass consciousness is essentially required for successful completion of this aim.
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