Open the pages of newspapers these days, and you are likely to find beleaguered parents — mostly mothers — soliciting financial help for their babies who were born with holes in the heart.
Physicians say holes in the heart — aka congenital heart defects — is a problem with the heart’s structure that is present at birth. They note that these defects change the normal flow of blood through the heart.
A study led by Prof. Bernard Keavney of the University of Manchester, and published in Nature Genetics, submits that CHDs occur in seven out of 1,000 babies born, and that it is one of the major causes of childhood death and illness.
“CHDs change the normal flow of blood through the heart,” experts say.
Scientists say the heart has two sides, separated by an inner wall called the septum.
They explain as follows: “With each heartbeat, the right side of the heart receives oxygen-poor blood from the body and pumps it to the lungs. The left side of the heart receives oxygen-rich blood from the lungs and pumps it to the body. The septum prevents mixing of blood between the two sides of the heart. However, some babies are born with holes in the upper or lower septum.”
Child and Public Health Physician with St. Ives Specialist Hospital, Dr. Rotimi Adesanya, notes that a hole in the septum between the heart’s two upper chambers is called an atrial septal defect, while a hole in the septum between the heart’s two lower chambers is called a ventricular septal defect.
He says both ASD and VSD allow blood to pass from the left side of the heart to the right side, making oxygen-rich blood to mix with oxygen-poor blood. “As a result, some oxygen-rich blood is pumped to the lungs instead of the body,” Adesanya says.
General practitioner, Dr. Emmanuel Ogbebor, notes that children who have simple congenital heart defects can survive to adulthood, and that they can live normal, active lives because their heart defects will close on their own and even if this doesn’t happen, the defect can be repaired.
Causes
But then, what causes heart defects in unborn babies? Experts say, broadly, there are two ways a child in the womb can develop heart issues — the first is unavoidable, while the second is avoidable.
Adesanya says heredity is the first unavoidable cause of congenital heart defects. He explains: “A parent who has a congenital heart defect is slightly more likely than other people to have a child who has the problem.”
However, Ogbebor says it’s very rare for more than one child in a family to be born with a heart defect, even where heredity is concerned.
Other unavoidable causes of heart defect are chromosomal abnormalities, Adesanya warns. “More than one-third of children with genetic disorders, such as Down syndrome, often have hole in the heart,” the paediatrician says.
Scientists at the Lucile Packard Children’s Hospital at Stanford University, California, USA, disclose that other chromosomal abnormalities that could contribute to having heart defects include Turner’s syndrome (a genetic disorder that affects a girl’s development, making her infertile); Cri du chat syndrome (a disorder that causes many symptoms, most of which affect facial features and motor skills); Wolf-Hirshhorn syndrome (a developmental disorder that affects many parts of the body, with characteristic facial appearance, delayed growth and development, intellectual disability, and seizures); and DiGeorge syndrome (a genetic disorder with varying effects on facial appearance, lack of/or underdeveloped thymus and parathyroid glands).
Ogbebor adds that though scientists continue to search for the causes of congenital heart defects, certain unhealthy but avoidable habits could predispose an unborn child to the disorder. For instance, the physician says, smoking during pregnancy has been linked to several CHDs, including septal defects.
Drinking alcohol during pregnancy can also lead to having babies with foetal alcohol syndrome, a situation that often makes babies have CHDs, Adesanya says.
Professor of Anatomy, Oladapo Ashiru, also warns that women who are exposed to organic solvents are three times more likely to give birth to a baby with congenital heart disease than the general population.
Experts say organic solvents are chemicals found in a wide range of products and substances such as paint, ink, nail polish, glue, household cleaners, etc.
The physicians also warn that taking certain medications while pregnant, especially in the first 13 weeks when the baby’s heart is still developing, can cause birth defects, including hole in the heart.
“Such drugs include benzodiazepines and lithium for seizure (epilepsy) control; isotretinoin and topical retinoids for treating acne; as well as analgesics (painkillers).
“That is why pregnant women are advised to consult their physicians before taking any medications whatsoever,” Ogbebor warns.
The Stanford scientists also say that mothers who have phenylketonuria but who do not adhere to the special diet necessary to manage the disease during pregnancy have a higher risk of having a child with CHD.
Phenylketonuria is a genetic disorder in which the body can’t process part of a protein called phenylalanine, which is present in almost all foods.
Diabetologist/Medical Director of Rainbow Specialist Medical Centre, Lekki, Dr. Afokoghene Isiavwe, also adds that women with insulin-dependent diabetes (particularly if the diabetes is not well-controlled) may have a higher risk of having a child with heart defects.
All the physicians urge women with these chronic illnesses to undergo medical counselling before becoming pregnant.
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