Fetal Heart Conditions Cared for by the Fetal Cardiology Program

The first weeks of pregnancy are a critical time for your baby's heart development. After only 22 days' gestation, the heart starts to beat, and by the end of week nine, its structures have formed. It's during this early development that fetal heart defects may occur. While most babies don't develop fetal heart conditions while in the womb, for nearly one of every 100 pregnancies, a fetal heart condition occurs.

The Colorado Fetal Care Center's Fetal Cardiology Program at Children's Hospital Colorado offers specialized care for fetal heart conditions while the baby is still in the womb. Through both in-person and virtual visits, we can help families care for all fetal heart conditions – from simple to complex.

Fetal heart conditions and the developing heart

Some fetal heart conditions may change the shape of the heart and the way blood flows, while others may cause a problem with the heart muscle or heartbeat. No matter their type, these conditions mean that the fetus's heart did not develop normally in the womb.

Terms to describe these fetal heart conditions are sometimes used interchangeably and can be referred to as congenital heart disease, fetal heart defects, fetal cardiac abnormalities and fetal anomalies. Your doctor will help you understand what type (or types) of fetal heart disease your baby has and the care options available.

What are the types of heart conditions in unborn babies?

We classify fetal heart conditions according to three main categories:

• Structural heart disease (congenital heart defects or disease)
• Heart muscle diseases (cardiomyopathy)
• Heart rhythm problems (arrhythmia)

The most common heart conditions in babies are structural congenital heart defects. Structural defects involve abnormal development of the fetal heart walls, valves or the blood vessels that carry blood to and from the heart. Learn all about fetal and congenital heart defects, their diagnosis and how we treat them at our nationally-ranked Heart Institute.

Fetal heart conditions we care for at the Fetal Cardiology Program

At the Colorado Fetal Care Center, our fetal cardiac specialists provide diagnosis, support and care for the full spectrum of fetal heart conditions.

Structural heart disease (congenital heart defects)

Structural heart disease occurs when one or more parts of the heart forms incorrectly. These defects may cause blood flow to go in the wrong direction, slow down, travel to the wrong place and/or be completely blocked.

In the Fetal Cardiology Program and Fetal Cardiology Telemedicine Program, our fetal cardiologists can prenatally diagnose and care for high-risk pregnancies affected by all structural heart defects, including:

Septal heart defects ("hole in the heart")

• Atrial septal defect (ASD)
• Atrioventricular canal defect (AVCD) or atrioventricular septal defect (AVSD)
• Ventricular septal defect

Heart valve defects

These fetal heart problems occur when the fetus's heart valves don't open or close correctly or are narrow or blocked, hindering blood flow. These structural heart defects commonly occur with other forms of congenital heart disease.

• Aortic valve stenosis (AVS) or atresia
• Ebstein's anomaly or tricuspid valve dysplasia
• Pulmonary valve stenosis or atresia
• Tricuspid atresia

See how the experts at our Heart Institute perform heart valve replacements without open heart surgery when our patients grow up.

Defects of the aorta and pulmonary artery

• Aortic atresia
• Coarctation of the aorta (CoA)
• Congenitally corrected transposition of the great arteries
• Double aortic arch
• Double outlet right ventricle
• Interrupted aortic arch
• Pulmonary atresia
• Right aortic arch
• Tetralogy of Fallot
• Transposition of the great arteries (TGA)
• Truncus arteriosus
• Vascular ring

Venous anomalies of the fetal heart

• Bilateral superior vena cava (SVC)
• Interrupted IVC
• Partially anomalous pulmonary venous return (PAPVR)
• Total anomalous pulmonary venous return (TAPVR)

Single ventricle defects

Single ventricle defects involve an anomaly of one of the heart's lower chambers. The chamber may be smaller, underdeveloped or missing a valve depending on the diagnosis. At Children's Colorado, we treat all forms of single ventricle heart disease and the issues related to these structural CHD, including:

• Double inlet left ventricle (DILV)
• Double outlet right ventricle (DORV)
• Hypoplastic left heart syndrome (HLHS)
• Hypoplastic right heart syndrome
• Mitral valve atresia
• Pulmonary atresia
• Single left ventricle
• Tricuspid atresia (TA)

Babies with this type of structural heart defect will need to undergo single ventricle surgery in the first year of life. Learn how we help children with a single ventricle heart disease at our Single Ventricle Care Program.

Situs abnormalities (abnormal position of organs in the body)

• Dextrocardia
• Heterotaxy syndrome
• Mesocardia
• Situs inversus

Other fetal heart conditions we care for and treat

• Absent ductus venosus
• Cardiac diverticulum
• Cardiac tumors, including fetal pericardial teratoma
• Ectopia cordis
• Generalized arterial calcinosis of infancy (GACI)
• Premature ductal closure

Please note that many fetal heart conditions involve a combination of several heart defects and may affect multiple parts of the heart. Talk with your fetal cardiologist to learn more about the nature of your baby's congenital heart disease diagnosis.

Heart muscle diseases (cardiomyopathy)

Cardiomyopathy encompasses fetal heart conditions that are diseases of the heart's muscle (myocardium). When a fetus has cardiomyopathy, their heart muscle doesn't work as well as it should (which can lead to heart failure).

The types of cardiomyopathy and heart muscle disease we care for include:

• Arrhythmogenic right ventricular dysplasia (ARVD)
• Dilated cardiomyopathy (DCM) or congestive cardiomyopathy
• High output heart failure
• Hypertrophic cardiomyopathy (HCM)
• Ischemic cardiomyopathy
• Left ventricular non-compaction cardiomyopathy (LVNC)
• Restrictive cardiomyopathy (RCM)
• Uhl's anomaly

Together with the Cardiomyopathy Program at our Heart Institute, we provide fetal diagnosis and cardiomyopathy treatment for babies with heart muscle diseases.

Fetal heart rhythm problems (arrhythmia)

Fetal heart conditions may also involve the heart's conduction system, which is responsible for making it beat at a normal rate. Sometimes the electrical impulses happen too rapidly, too slowly or erratically, causing the heart to beat too rapidly, slowly or erratically. These fetal heart rhythm problems are called cardiac arrhythmia (or dysrhythmia).

We care for all kinds of fetal arrhythmias, including:

• Tachycardia (too fast)
  • Accessory pathway medicated tachycardia (SVT)
  • Atrial flutter
  • Atrial fibrillation
  • Chaotic atrial tachycardia
  • Premature junctional reciprocating tachycardia (PJRT)
  • Sinus tachycardia
  • Ventricular tachycardia
• Irregular heart rhythms
  • Premature atrial contractions
  • Premature ventricular contractions
• Bradycardia (too slow)
  • Congenital heart block (types 1, 2 and 3), secondary to maternal anti-Ro/SSA antibodies
  • Blocked atrial bigeminy
  • Sinus bradycardia

Learn how our pediatric partners at the Heart Institute's Pediatric and Adult Congenital Electrophysiology Program treat kids with abnormal heart rhythms.

Why choose the Fetal Cardiology Program for your baby's fetal heart condition?

At the Colorado Fetal Care Center, we provide the full range of fetal, obstetric and pediatric cardiac expertise necessary to care for virtually all fetal cardiac abnormalities. Our Fetal Cardiology Program is here to offer care from the time of diagnosis until your child reaches adulthood.

Our goal is not only to provide treatment for babies with CHD, but to support the entire family as well. With compassionate support services like dedicated care coordinators to handle scheduling, travel and lodging and concierge style cardiac care, we aim to alleviate some of the stress that comes with a fetal heart condition diagnosis. Learn about your visit to our fetal care center.

Prenatal diagnosis of fetal heart defects

With state-of-the-art fetal echocardiography and telemedicine technologies and unparalleled experience, the fetal cardiologists at our Fetal Cardiology Program can diagnose potentially fatal fetal heart conditions at the earliest possible detection – at just 14 weeks' gestation.

By prenatally diagnosing fetal heart defects, we can optimize your unborn baby's health, care and delivery, giving them the best possible chance at a positive outcome. And thanks to our program that performs prenatal screening for critical congenital heart disease, we can give every baby born here at Children's Colorado that chance as well.

Complex delivery planning for heart defects

Few fetal heart conditions can be treated in utero, and in most cases, treatment is only possible at or after birth. Our multidisciplinary team of maternal fetal, fetal, pediatric, cardiology, neonatology and pulmonary specialists collaborate to create optimal delivery and treatment plans that allow for coordinated, immediate care after delivery.

Our state-of-the-art Maternal Fetal Care Unit is specially designed for delivering high-risk babies like yours. Should you deliver here, you'll do so with every pediatric subspecialist your baby may need on standby. And we'll deliver your baby right into the hands of our skilled cardiac care team that's ready to treat or take them to our specialized Cardiac Intensive Care Unit (CICU).

Comprehensive, expert fetal cardiac care for moms and babies across the country

With some of the best outcomes in the nation, unparalleled experience and innovative telemedicine capabilities, our MFMs and fetal cardiologists can provide vital care for your baby throughout your entire pregnancy, no matter where you live. Learn more about fetal cardiology telemedicine at the Colorado Fetal Care Center.

See why our outcomes make us one of the top heart hospitals