Althea A. Fung


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Prenatal Care Can Make a Difference in a Child’s Life — Everyday Health

From the backseat, 18-month-old Alex DeCrane Sloan babbles a mile a minute while his parents make the hour-long drive to Children’s Hospital of Illinois for his routine checkup.

Listening to Alex’s spirited baby talk, you’d never guess that this boisterous toddler had once faced a life-threatening heart condition that required critical prenatal care. 

Alex’s mother, Jessica DeCrane, does.

“If I hadn’t sought prenatal care, I would have delivered in a local hospital, where they probably wouldn’t have been prepared to treat him,” she says. “I probably wouldn’t have my son.”

During Jessica’s pregnancy, a routine ultrasound picked up something amiss with Alex’s heart. Jessica’s doctor referred her to Children’s Hospital, where she had a fetal echocardiogram. Alex had congenital heart disease—a structural problem that develops in the heart before birth. A congenital heart defect can disrupt blood flow, which may lead to heart failure.  If the defect is found before delivery, the story can have a much happier ending.

At Children’s Hospital, Jessica worked with a team of experts who specialize in maternal and fetal medicine. The team included pediatric cardiologist Matthew Bramlet, MD, medical director of echocardiography at the Congenital Heart Center. He said the medical team quickly developed a plan of action to ensure Alex’s survival upon delivery. A surgery right after birth by Dr. Randall Fortuna, and a second surgery several weeks later addressed the problem.

“Alex’s condition is the perfect example of the importance of prenatal screening and diagnosis,” says Dr. Bramlet. “A life was saved because of immediate intervention.

“If he had been born without prenatal diagnosis and planning,” Dr. Bramlet adds, “his condition would have been instantly evident because he would have been born blue. But the chances of his surviving the trip to Children’s Hospital would have been slim. Even if he had been delivered at our hospital, without prior knowledge of the condition, it would have taken more than an hour for staff to mobilize—an hour we might not have had.

In fact, the pediatric catheterization team was waiting for Alex’s arrival. Alex went from delivery to catheterization in an astonishing 19 minutes, according to Dr. Bramlet. At Children’s Hospital, doctors of all subspecialties work together to detect prenatal conditions as early as possible.

“Only 20 percent of congenital heart lesions occur in high-risk pregnancies. That means 80 percent happen in normal pregnancies,” Dr. Bramlet says. “Unfortunately, not all sonographers have formal training in congenital heart disease. It is this gap in education that we feel offers the most potential for improving prenatal diagnosis.” 

Dr. Bramlet works closely with maternal fetal medicine subspecialists to offer fetal seminars each year to help sonographers who use ultrasounds and other screening tools check for signs of congenital heart conditions and other disorders. While prenatal diagnosis and treatment are the primary focus at Children’s Hospital, the efforts of care professionals are lost without the hard work and keen eye of those in the community who are the first to identify fetal complications.

Early diagnosis was a lifesaver for Alex and his family. “When I found out everything, it was scary and really emotional,” Jessica says. “Throughout my pregnancy, doctors at Children’s Hospital reassured me there was a way to fix Alex’s heart.”

Alex continues to see Dr. Bramlet for followup. But Dr. Bramlet smiles and says that, as Alex ages, he’ll likely be able to participate in all the horseplay a little boy enjoys.