Definition

Fetal cardiac dysfunction refers to a number of heart problems in a growing fetus. For example, the heart can be:

• Pumping weakly
• Pumping irregularly

The heart is not adequately able to move blood through the fetus’ body. This can cause distress in the fetus. The condition can range from mild to severe.

Causes

Cardiac dysfunction may be due to:

• Genetic diseases that affect the heart
• Problems with structures of the heart
• Infections
• Exposure to certain substances such as drugs, alcohol, nicotine, and some medications

Risk Factors

General risk factors for heart problems include:

• Family history of congenital heart defects
• Certain chromosomal disorders in the child
• Previous pregnancy with fetal heart abnormalities or miscarriage
• Conditions during pregnancy, such as:
  • Being infected with a virus such as rubella
  • Having poorly controlled diabetes
  • Drinking alcohol
  • Taking certain medications, such as isotretinoin for acne
  • Poor blood supply to the fetus

Symptoms

The symptoms depend on the type of defect. The doctor will monitor your baby’s growth and heart rate during the pregnancy. During fetal monitoring, the doctor may detect an abnormal heartbeat, such as:

• Irregular, extra, or missed heartbeats
• Heart beats too fast—tachycardia
• Heart beats too slowly—bradycardia

During imaging tests, the doctor may also detect:

• Abnormal heart structure
• Blood flow problems

Diagnosis

Fetal cardiac dysfunction can be detected using special tests during pregnancy.

Images may be taken of your abdomen. This can be done with:

• Fetal ultrasound
• Fetal echocardiogram
• Fetal MRI scan

Your fetus’ fluids may be tested. This can be done with amniocentesis.

Treatment

Talk with the doctor about the best treatment plan for your baby. During your pregnancy, you will need to be examined by specialists, such as:

• Perinatologist or maternal-fetal medicine specialist—a doctor who specializes in the treatment of high-risk pregnancies
• Pediatric cardiologist—a doctor who specializes in heart conditions in children

There are many categories of this condition. Treatment depends on the type of defect. In certain cases, the problem can resolve on its own.

In other cases, the condition may be treated during the pregnancy. For example, surgery may be done to repair abnormal structures while the baby is in the uterus.

Your baby may need medications or surgery after birth. Examples of surgeries that may be done include:

• Catheterization—a tube is inserted through the veins and into the heart for testing or a procedure
• Pacemaker insertion—a small, battery-operated device is inserted into the heart to maintain a normal heartbeat

Prevention

To help reduce your chance having a baby with heart defects:

• Visit your doctor regularly. Your doctor will monitor your health and the health of your baby. Certain tests may be able to detect a heart defect in a growing fetus.
• Have a healthy lifestyle. Eat healthy food and take prenatal vitamins.
• Do not drink alcohol, smoke, or use drugs. This is especially important if you are pregnant.

Healthy Children—American Academy of Pediatrics http://www.healthychildren.org

Heart and Stroke Foundation of Canada http://www.heartandstroke.ca

Congenital heart defects. Nemours Kid’s Health website. Available at:
http://kidshealth.org/parent/medical/heart/congenital_heart_defects.html
Updated January 2012. Accessed July 19, 2013.

Fetal echocardiography/Your unborn baby’s heart. American Heart Association website. Available at:
http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/SymptomsDiagnosisofCongenitalHeartDefects/Fetal-Echocardiography-Your-Unborn-Babys-Heart_UCM_315640_Article.jsp
Accessed July 19, 2013.

Special tests for monitoring fetal health. American Congress of Obstetricians and Gynecologists website. Available at:
http://www.acog.org/~/media/For%20Patients/faq098.pdf?dmc=1&ts=20130719T0549108390
Accessed July 19, 2013.