How coronavirus is affecting the detection and treatment of congenital heart defects

These are uncertain times. Sonographers are still undertaking pregnancy scans. Babies with congenital heart defects will still be diagnosed. The fetal anomaly scan is still the best opportunity to detect congenital heart disease (CHD) before a baby is born. Coronavirus doesn’t change that fact. Therefore, we remain focused on doing what we can to help babies with congenital heart defects, their families, and the health professionals who look after them.

Here our Head of Training, Anne Rhodes, talks about how Coronavirus is affecting the detection and treatment of congenital heart defects:

Have you been told at your antenatal scan that there may be a problem with your baby's heart?“There is no doubt that there will be direct consequences of coronavirus for the CHD community. High risk pregnancies, which would ordinarily be referred for echo, will now be relying on sonographers from the main departments – often trained by Tiny Tickers. At present we are unable to offer that training.

There is more potential for babies to not have their heart defects detected. Some hospitals are carrying out the high risk scans already booked, but are not adding any more to the list.

There are many reasons why we would suggest training is as important as ever, even if it is virtually (we are actively trying to move our training offer online as I type this!) Sonographers will be under more pressure to provide, and even maintain the services that are currently in place. There will be an inevitable lack of staff due to self isolation or illness.

The International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG) advises that departments attempt to shorten the duration of the examination, by arranging for the most experienced sonographer to perform the scan. Sonographers need to wear basic personal protective equipment (PPE) which includes an apron, gloves and a mask to cover their nose and mouth. They should also inform the patient that a detailed explanation will not be given during the examination.

Sonographer conducting a 20 week pregnancy scanWhat would have been a friendly, welcoming and comfortable environment for the patient is now far more clinical. Some may perceive it as a cold setting.

So, the sonographer’s role has now become a lot more pressured and difficult.

Sonographers being able to access training, whether through a course online or via webinars, will be paramount in giving them more confidence during these difficult times in spotting CHD.

Breaking bad news to patients has always been challenging, but adding in the fact that women now have to now come alone to appointments and be counselled by sonographers in face masks, who can only offer comfort to patients whilst considering social/physical distancing, makes this situation so much harder.

The human face is extremely expressive and is able to convey countless emotions. Wearing face masks takes away the invaluable aspect of this non-verbal communication.

Once a referral has been made and a diagnosis given by the cardiologist, women are seen alone and may even have to be counselled alone. Then, while their heads are still reeling with the often devastating news they have just received, they will have to relay this information to their partners.

Added to this are the effects on the treatment of heart defects. Some elective surgeries are being cancelled, some units aren’t operating for urgent surgery, only one parent can be at the hospital, outpatient clinics are cancelled and support is having to be given at arms length because of social distances.

The ‘normal’ treatment of congenital heart defects is tough enough. Now the need has never been higher, just as the journey gets that bit more difficult.

We are in uncharted territory, and it is difficult to understand what impact this will have on the detection rates of CHD, and more importantly, the long term effects for those families who are at the start of their CHD journey.

Stay safe,