pulmonary stenosis in fetus :: Article CreatorWhat To Know About Pulmonary Valve Stenosis
Pulmonary valve stenosis can be both congenital (present at birth) or something adults develop later on in life. It can range in severity from mild to severe cases. Often, a person may not know they have the condition until years down the road.
In a substantial amount of cases, the patient is able to go through life without any major issues. In moderate cases, some medical procedures may be required. It is common to see the doctor every few months in order to monitor the success of the procedures.
In some severe cases, surgery is required, and physical activity is restricted until the patient shows signs of improvement.
Pulmonary valve stenosis (PVS) is a condition that affects the heart. The heart has the important job of maintaining proper blood flow throughout our bodies. It needs to remain strong and functioning for us to maintain good health.
The heart is a muscle that contains four chambers:
The left atrium (top left) The right atrium (top right) The left ventricle (bottom left) The right ventricle (bottom right) After its journey through the body, blood is pumped back into the heart. From there, it enters the right side. It goes from the right atrium into the right ventricle, then through the pulmonary valve. Then, it receives fresh oxygen from the lungs and continues through the body once more.
Picture the pulmonary valve as a one-way door. It has small flaps that allow blood to flow through it one way, with no way of getting back.
In people with pulmonary valve stenosis, the blood has a hard time making its way through the pulmonary valve. This is usually because the valve is too narrow.
The heart has its own way of dealing with this issue. Because it has to work extra hard to force blood through that small opening, it does what any other muscle might do when it gets overworked: become larger and thicker. Unfortunately, this can put a strain on heart function.
PVS isn't a disease; it's an abnormality that usually happens during the heart's development. Doctors don't know the exact cause of PVS, but it isn't caused by anything a mother did or didn't do during her pregnancy.
PVS can be present on its own or alongside other heart defects. Some known causes of PVS include:
Rubella infection of the mother during pregnancy can cause PVS in the baby William's syndrome, a genetic disorder that causes a child developmental delays, can also cause PVS Who is at risk of developing this condition? Most people who have it are born with it. Babies' heart valves form during the first 8 weeks of pregnancy, so it's possible that this condition could be passed genetically from parent to child.
If a mother gets rubella, also known as German measles, during pregnancy, there is a higher chance the baby will develop pulmonary valve stenosis.
The illness can also occur if a baby has Noonan syndrome. Noonan syndrome is a genetic condition that is typically passed down from parent to child. It can cause short stature, unusual facial characteristics, and heart development issues.
In adults, rheumatic fever and carcinoid syndrome can put you at risk of getting pulmonary stenosis. Both these diseases can cause damage to your heart valves.
Williams syndrome is a rare disorder few babies are born with. It's characterized by certain facial features that get more pronounced with age and slow mental development. People born with Williams syndrome, also called Williams-Beuren syndrome, are at risk of developing PVS among other heart defects.
In some mild cases of valve stenosis, you might not notice symptoms at all. You may go for a routine check-up, and your doctor might find it when they listen to your heart with a stethoscope.
Symptoms of severe pulmonary valve stenosis in babies may also manifest, though, in an obvious way: They may show some blue coloration (cyanosis).
Some common symptoms of moderate pulmonary valve stenosis can include:
Feeling tired or very short of breath after a short amount of exercise Fast breathing and heart rate A bluish color around the lips and fingertips Fainting Chest pain Swelling in the hands and feet, legs, belly, or face General fatigue Sometimes, symptoms only present during exercise.
Pulmonary valve stenosis can sometimes be diagnosed before birth. A fetal echocardiogram, (also known as a fetal echo) can show pictures of what a fetus' heart looks like while they're still growing inside the mother.
If you suspect that you or your child has pulmonary stenosis, you might visit the doctor, and they will decide which tests to perform. Some of those tests can include:
X-ray. Chest X-rays can show changes to or structural problems within your heart. Echocardiogram. Similar to an imaging test performed on an unborn baby, this test uses sound waves to create pictures of your heart. It is one of the most accurate diagnostic tools. Electrocardiogram (ECG). This test tracks the rhythms of the heart. It can detect areas of stress in the heart and record electrical activity. Cardiac catheterization. Doctors are usually able to diagnose pulmonary stenosis with other tests. A cardiac catheter is more invasive and will usually be used as a last option. A tube is inserted in the groin area and pushed up to the heart. They will check each of the four chambers of the heart for circulation issues and problematic blood pressure. A dye is often used to measure how efficiently the heart is pumping blood. Magnetic Resonance Imaging (MRI). MRI tests can sometimes be ordered depending on what equipment the doctor has available. Before your doctor's visit, write down any symptoms you or your child have experienced. Think of your family's health history and make note of any concerns. Also, write down any questions you have for your doctor.
If you are taking any medications or supplements, make a list and have it readily available.
If you are seeing your general practitioner or family doctor, they will likely perform a general check-up and possibly order an imaging test. Depending on the results of the test, you could be referred to a heart specialist.
If you see a specialist, you might consider gathering some information about how this condition can affect everyday life. For instance, you may ask:
Can you or your child participate in sporting activities or exercise? If so, which ones are safe? What could be a possible cause of this condition? Is there a certain heart rate number you should aim to stay under? Is a heart rate or blood pressure monitor necessary for you? What are the treatment options, and what risks and benefits does each option carry? Are there any additional educational resources such as websites or reading material that could be beneficial? The doctor will have some questions for you too. They could be related to how you or your child are experiencing the symptoms in terms of time duration or what they are doing when the symptoms appear.
In mild cases, no treatment is needed other than regular follow-ups with your doctor. If the symptoms are moderate to severe and are interfering with your quality of life, you might consider the following treatment options:
Balloon valvuloplasty. An un-inflated balloon is placed on the end of a catheter and brought into the small heart valve using imaging tests as a guide. The balloon is then inflated, stretching the pulmonary valve open. This is one of the most common treatments. It's possible that the valve can return to its original size after the treatment. Pulmonary valve replacement. The heart valve can be replaced by undergoing surgery. An artificial valve or donor valve is used. This procedure is performed on a case-by-case basis and depends on other factors the patient might be going through. Valvotomy. If there is scar tissue on the pulmonary valve causing less blood to flow through, corrective surgery can be performed to remove the scar tissue. It's important to remember that although the valve may function normally after surgery, it will need to be monitored regularly, and precautions must be taken during some medical procedures.
Complications can arise whether you've had corrective treatment or not. For example, if you undergo a valve replacement, there are several safeguards you must have in place to prevent inflammation or infection of the valve.
Endocarditis is one such risk. It's a bacterial infection that settles into the lining of the heart. It can be especially threatening to someone who's had heart surgery or has a heart condition.
Most people who have had valve replacement surgery will need to take antibiotics before any dental or medical procedures in order to prevent endocarditis.
Other complications of pulmonary valve stenosis can be:
The heart muscle thickens. Because the heart has to work harder to pump blood, the walls of the heart can get thick. This can cause extra strain on the heart. Irregular heartbeat. Also known as arrhythmia, this can happen in people with valve stenosis. In severe cases, your doctor might recommend treatment. Heart failure. In severe cases, the heart could fail because it's working extremely hard to pump blood, and not enough blood is going through it. Pregnancy complications. If you have pulmonary valve stenosis, it can interfere with your pregnancy. It depends on the severity of your case and how the health of your heart valve has been maintained. TORCH Syndrome: A Silent Threat To Your Pregnancy
About
TORCH syndrome is a medical acronym that refers to a group of congenital infections that can cause significant morbidity and mortality in newborns. This syndrome encompasses a range of infections that are transmitted from a pregnant mother to her fetus, leading to serious health issues in the infant. The acronym TORCH stands for Toxoplasmosis, Other (such as syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes simplex virus (HSV). These infections can result in severe developmental anomalies, organ damage, and even fetal death(1✔ ✔Trusted SourceTORCH Complex
Go to source).
Did You Know? The risk of birth defects is highest if a woman is infected with a TORCH virus for the first time during pregnancy. This is because the developing baby's organs are still forming. #TORCH #congenitalinfections #medindia Toxoplasmosis
Causative Agent: Toxoplasmosis is caused by the protozoan parasite Toxoplasma gondii
Transmission
Maternal Infection: Usually acquired through ingestion of oocysts from contaminated food, water, or soil, or by consuming undercooked infected meat. Vertical Transplacental Transmission: The parasite crosses the placenta, especially during acute maternal infection. Fetal Impact: The parasite can infect various fetal tissues, leading to inflammation and tissue damage. The severity of damage depends on the gestational age at infection, with earlier infections causing more severe outcomes. Advertisement
Clinical Manifestations
Neonatal:
Hydrocephalus: Accumulation of cerebrospinal fluid in the brain, leading to an enlarged head. Chorioretinitis: Inflammation of the retina and choroid, which can cause vision problems or blindness Intracranial Calcifications: Abnormal calcium deposits within the brain Seizures: Due to neurological involvement Long-term:
Cognitive Impairment: Developmental delays and learning difficulties Vision Loss: Progressive vision impairment or blindness Hearing Loss: Sensorineural Hearing loss Other Infections Syphilis
Causative Agent: Treponema pallidum
Mechanism
Maternal Infection: Syphilis is primarily a sexually transmitted infection. It can also be transmitted through blood transfusion or direct contact with syphilitic sores Transplacental Transmission: Treponema pallidum can cross the placenta at any stage of maternal infection, but transmission is more likely during primary and secondary stages of syphilis Fetal Impact: The spirochete bacterium can infect the fetus, causing widespread systemic infection, inflammation, and damage to multiple organs and tissues Clinical Manifestations
Hepatosplenomegaly: Enlarged liver and spleen. Jaundice: Yellowing of the skin and eyes due to liver dysfunction. Skin Rashes: Characteristic rash, often involving the palms and soles. Skeletal Abnormalities: Including periostitis, osteochondritis, and saddle nose deformity. Neurological Symptoms: Neurological involvement can cause developmental delays, seizures, and other nervous system abnormalities. Advertisement
Varicella-Zoster Virus
Causative Agent: Varicella-zoster virus (VZV)
Mechanism
Maternal Infection: Acquired through respiratory droplets or direct contact with vesicular lesions. Varicella (chickenpox) is highly contagious. Transplacental Transmission: Can occur if the mother contracts varicella during pregnancy, particularly during the first or second trimester. Fetal Impact: The virus causes cell death and inflammation in fetal tissues, leading to congenital varicella syndrome, which can result in a range of severe abnormalities. Clinical Manifestations
Skin Lesions: Scarring and limb hypoplasia (underdevelopment of limbs). Limb Abnormalities: Underdevelopment or deformities of limbs. Ocular Abnormalities: Cataracts, chorioretinitis, and microphthalmia (abnormally small eyes). Neurological Symptoms: Microcephaly (small head size), seizures, and developmental Systemic Symptoms: Low birth weight, prematurity, and potential multisystem involvement. Parvovirus B19
Causative Agent: Parvovirus B19
Transmission
Transplacental Infection: Parvovirus B19 can cross the placenta from an infected mother to the fetus. The virus is primarily transmitted to the mother through respiratory droplets but can also be acquired through blood transfusions. Clinical Manifestations
Neonatal
Fetal Anemia: Parvovirus B19 infects and destroys red blood cell precursors, leading to severe anemia in the fetus. Hydrops Fetalis: This is a serious condition characterized by severe edema in the fetus, resulting from heart failure due to anemia. Myocarditis: Inflammation of the heart muscle, which can lead to heart failure. Advertisement
Rubella
Causative Agent: Rubella virus
Transmission
Maternal Infection: Acquired through respiratory droplets from an infected person. Vertical Transmission: The Rubella virus can cross the placenta from an infected mother to the fetus, particularly during the first trimester of pregnancy, which poses the highest risk of severe congenital anomalies. Clinical Manifestations
Neonatal:
Congenital Rubella Syndrome: This syndrome includes a constellation of symptoms such as: Cataracts: Clouding of the lens of the eye, leading to vision impairment or blindness. Cardiac Defects: Including patent ductus arteriosus (PDA) and pulmonary artery stenosis. Sensorineural Deafness: Hearing loss due to damage to the inner ear or auditory nerve. Microcephaly: Abnormally small head size due to impaired brain development. Long-term:
Developmental Delays: Cognitive and motor delays, including difficulties with learning and coordination. Endocrinopathies: Increased risk of developing conditions such as diabetes mellitus and thyroid dysfunction. Cytomegalovirus (CMV)
Causative Agent: Cytomegalovirus (CMV), a member of the herpesvirus family.
Transmission
Maternal Infection: CMV can be transmitted through primary infection or reactivation of a latent infection. It is commonly spread through body fluids, such as saliva, urine, blood, and sexual contact. Vertical Transmission: CMV can be transmitted trans-placentally from an infected mother to the fetus, during delivery through contact with the birth canal, or postnatally through breast milk. Clinical Manifestations
Neonatal
Microcephaly: Abnormally small head size with potential for severe neurological impairment. Periventricular Calcifications: Calcium deposits around the brain's ventricles, indicative of brain damage. Hepatosplenomegaly: Enlargement of the liver and spleen. Jaundice: Yellowing of the skin and eyes due to liver dysfunction. Petechiae: Small red or purple spots on the body caused by minor bleeding under the skin. Long-term
Hearing Loss: Progressive sensorineural hearing loss, often detected later in childhood. Vision Impairment: Due to conditions such as chorioretinitis. Intellectual Disability: Cognitive and developmental delays. Motor Deficits: Issues with muscle control and coordination, potentially leading to difficulties with movement and posture. Herpes Simplex Virus (HSV)
Causative Agent: Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2)
Transmission
Maternal Infection: HSV-1 typically causes oral herpes, while HSV-2 is usually associated with genital herpes. Both types can be transmitted to the neonate. Vertical Transmission: During Delivery: The most common mode of transmission, occurring when the baby comes into contact with infected genital secretions during birth. Transplacental Transmission: This is less common but can occur if the mother has a primary HSV infection during pregnancy. Postnatal Transmission: Can occur through contact with infected caregivers, usually resulting in localized skin infections. Clinical Manifestations
Neonatal
Skin, Eye, and Mouth Lesions (SEM Disease): Vesicular lesions on the skin, around the eyes, and in the mouth. This form of the disease is localized and less severe. Encephalitis: Inflammation of the brain, which can cause seizures, lethargy, irritability, poor feeding, and bulging fontanelle. Disseminated Infection: Involvement of multiple organs, including the liver, lungs, adrenal glands, and central nervous system. This form is the most severe and can be life-threatening. Long-term
Neurological Impairment: Due to encephalitis, resulting in developmental delays, intellectual disabilities, and motor deficits. Seizures: Chronic seizure disorders can develop as a result of brain damage. Recurrent Skin Lesions: Periodic reactivation of the virus can cause recurrent vesicular eruptions on the skin.
Did You Know? Most pregnant women who are infected with a TORCH virus will not have a baby with birth defects. However, there is a risk of serious problems, such as microcephaly (a small head), intellectual disability, vision problems, hearing loss, and heart defects. #TORCHsyndrome #medindia Prenatal Diagnosis
Ultrasound: Can detect anomalies such as hydrocephalus, microcephaly, and organomegaly and also to detect signs of fetal infection. Amniocentesis: To directly test for infections in the amniotic fluid. Maternal Serology: To determine mother's immunity status and detect recent infections. Neonatal Diagnosis
Clinical Examination: To identify characteristic signs and symptoms of TORCH infections. Laboratory Testing: Blood tests for specific IgM antibodies, PCR for Detecting viral DNA or RNA from blood samples, and culture for bacterial infections. Imaging: CT or MRI to detect intracranial abnormalities and other structural defects. Prenatal Management
Preventive Measures:
Vaccination: Rubella- Ensure women of childbearing age are vaccinated against rubella prior to pregnancy. Avoiding Raw or Undercooked Meat: To prevent toxoplasmosis, pregnant women should avoid consuming raw or undercooked meat and practice safe handling of food. Good Hygiene Practices Handwashing: Regular handwashing, especially after handling soil, cat litter, or raw meat. Avoiding Contact with Infected Individuals: Pregnant women should avoid close contact with individuals known to have infections like CMV or rubella. Maternal Treatment:
Antimicrobial Therapy: Syphilis: Treated with antibiotics, typically penicillin. CMV: Antiviral therapy, such as ganciclovir or valganciclovir, may be considered in certain cases. Toxoplasmosis: Treatment with antiparasitic medications such as spiramycin or a combination of pyrimethamine and sulfadiazine with folinic acid. Neonatal Treatment
Antibiotics and Antivirals:
Specific Infections: HSV: Treated with acyclovir to reduce viral replication and manage symptoms. Syphilis: Treated with penicillin. CMV: Antiviral medications like ganciclovir or valganciclovir can be used in symptomatic neonates. Supportive Care
Managing Symptoms and Complications: Anticonvulsants: For controlling seizures, often used in cases with CNS involvement. Physical Therapy: For infants with motor deficits to improve muscle strength and coordination. Nutritional Support: Ensuring adequate nutrition, sometimes requiring specialized feeding techniques. Follow-up
Regular Monitoring: Hearing and Vision Assessments: Regular check-ups to detect and manage any sensory impairments early. Developmental Evaluations: Monitoring for cognitive, motor, and developmental milestones. Endocrine Function: Screening for conditions like diabetes mellitus in those at risk due to congenital infections. Maternal Screening
Preconception Screening: Women planning to conceive should be screened for immunity and infection status, particularly for rubella and toxoplasmosis. Prenatal Screening: Regular screening during pregnancy to monitor for infections such as CMV, syphilis, and HIV. Screening can include serological tests for specific antibodies (IgM and IgG) to detect recent or past infections. Immunizations: Women of childbearing age should receive the rubella vaccine at least one month prior to conception to ensure immunity and prevent congenital rubella syndrome. Public Health Measures
Education: Educating women about the risks of consuming raw or undercooked meat, unpasteurized dairy products, and contaminated water to prevent infections like toxoplasmosis and listeriosis. Promoting good hygiene practices such as regular handwashing, avoiding contact with cat litter, and not sharing eating utensils with young children to reduce the risk of CMV and other infections. Informing women about the risks associated with close contact with infected individuals and providing guidance on how to minimize exposure to infectious agents. Screening Programs: Implementing comprehensive screening programs for pregnant women to identify and manage infections early. This includes routine prenatal visits with serological testing and ultrasound examinations to detect any signs of fetal infection. Ensuring newborns are screened for signs of TORCH infections, particularly if maternal infection is suspected or confirmed. Early identification allows for prompt treatment and management of complications. Early Diagnosis and Intervention
Early diagnosis and appropriate treatment can significantly improve outcomes for infants with TORCH infections.
Long-term Outcomes
While some infants may recover completely, others may experience long-term complications such as developmental delays, sensory impairments, and neurological deficits.
In summary, TORCH syndrome encompasses a group of infections that can lead to significant neonatal morbidity and mortality. Understanding the etiology, clinical manifestations, diagnostic approaches, and management strategies is essential for healthcare providers to ensure optimal outcomes for affected infants. Preventive measures, early diagnosis, and timely intervention are crucial components in mitigating the impact of these congenital infections.
Police Investigating Fetus Discovered On Bus In Baltimore
A fetus was discovered Saturday afternoon on a bus in Baltimore, Maryland, according to officials.
Baltimore Police and Maryland Transit Administration (MTA) police announced that a fetus had been found on an MTA Green Route bus.
Police responded around 12:40 p.M. To the 2500 block of Kirk Avenue after an MTA bus driver reported finding a fetus on a seat inside the bus.
FLORIDA BABY FOUND DEAD IN DUMPSTER WAS CHILD OF WOMAN ILLEGALLY IN US
A fetus was discovered Saturday afternoon on a bus in Baltimore, Maryland. (REUTERS/Jordan Vonderhaar)
The bus was headed south when the unusual discovery was made. The bus travels between Towson and Downtown Baltimore.
"Even though I wasn't on the bus, just to know something happened like that on the bus, that's what we're going through these days," resident Jeff McKoy told WBAL, noting that he frequents the area.
The incident remains under investigation.
This comes after other incidents in recent months of babies being discovered in abnormal locations.
'LATE-TERM FETUS' DISCOVERED IN VIRGINIA POND, POLICE IMMEDIATELY LAUNCH DEATH INVESTIGATION
An MTA bus driver reported finding a fetus on a seat inside the bus. (Getty Images)
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Last month, a dead baby was found in a dumpster in Florida. Brusela D'Enstachio-Lugo, 34, admitted to giving birth to the child outside of her home on May 10. She said she did not know she was pregnant and that she did not go to the hospital because she was in the country illegally and did not have money to pay for medical expenses. She also admitted to putting the infant's remains in the dumpster.
D'Enstachio-Lugo was charged with a misdemeanor related to the storage of human remains. Her DNA was collected and the Department of Homeland Security was contacted.
In March, police in Leesburg, Virginia, said a community member found a "late-term fetus" in a pond.
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