Friday, May 26, 2017

The Babies' Fetal Echocardiogram

The babies (and I) are continuing to grow big and strong!  Things are going very well with my pregnancy, which makes Adam and I extremely happy.  Our latest appointment with our maternal fetal medicine specialist was this past Tuesday, May 23, 2017.  Adam and I were both nervous about this appointment and ready to get it behind us.  This was the appointment where the babies would each have a fetal echocardiogram.  

An echocardiogram is essentially an in-depth look at the heart.  It is performed like a typical sonogram. The sonographer looks closely at the structure of the heart (the chambers, the valves) and the function of the heart (the blood flow).  With twins there is a higher risk of heart defects.  The fact that our first baby had significant heart defects also increased the risk of our twins having heart defects.  With all of these risk factors in place, Adam and I were trying to maintain positive thoughts, but were also worried that there was a very real chance that one or both of our babies would have heart issues.  

Earlier sonograms had been able to tell us that each of our babies' hearts had 4 chambers.  This was a relief and definitely helped calm some of our fears.  But the fact remained that there are lots of different types of heart defects.

It seemed like the echocardiogram took forever!  And my babies were being a bit ornery, which made it difficult for the sonographer to get all the measurements and views she needed.  After trying some different positions and drinking some cold water, the sonographer was able to get most of the views she needed.  As she was getting all the views and measurements, I was trying to compare each of the babies' numbers to see if any were wildly different.  With my lack of medical knowledge, I couldn't figure much out.  I was also trying to read the sonographer's facial expressions.  (On a side note, I think sonographers would make fantastic poker players, because I can never figure out what they are thinking!)

Afterwards, we went to wait in a conference room while Dr. Lu looked over the measurements and views. This was a difficult wait.  It brought back memories of us getting the devastating news of our first baby's heart problems.  Eventually Dr. Lu came into the room.  

After greeting us and asking how things were going, he reached for a picture of a diagram of the heart.  I about lost it at this point.  I knew he wouldn't need to show us a heart diagram if our babies' had healthy hearts.

He told us that the structures of each baby's heart looked great.  They had all the chambers and valves they should have and they all seemed to be functioning correctly.  He also said the direction and amount of blood flow was normal, as well.  

Then he reached for his pen.  He told us that they did find one minor issue with Baby A's heart, our son's heart.  He explained that every baby has an opening between the left and right side of their hearts called a Patent Foramen Ovale (PFO).  There's a little flap of tissue that will eventually cover this opening.  The flap of tissue is supposed to be flat and linear.  Our son's flap is more curved and sac-like.  The concern with this is that it might not close properly or if it does close, there might be an extra bit of tissue hanging around.  The official name of this is an Atrial Septal Aneurysm.  There is an increased chance of stroke later in life in people who have this type of defect.


The good news is that this particular defect is very minor.  There's a good chance that it will straighten out and close on it's own.  Dr. Lu said it wasn't a huge concern, just something we should be aware of.  His recommendation is for our son to have an echocardiogram once he's born to check on things.  

We asked what the chances were of him having to have some type of heart surgery and he said it wasn't anything we needed to be worried about right now.  He also said there's some controversy surrounding surgery to fix this defect.  Heart surgery itself poses a risk of stroke, so you have to weigh the risk of stroke during surgery with the risk of stroke later in life.  

So I am going to take Dr. Lu's advice and not worry about this right now.  Chances are it will fix itself all on its own and that will be the end of that.  Realistically, this is very minor.  Adam and I feel incredibly lucky that this is the only thing that came up during the heart echo.  We walked out of the office relieved and extremely grateful that our babies don't have any significant heart issues!  

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