The Follow-Up Ultrasound

  Needless to say, the next 5 weeks were the longest weeks of my life!  Every imaginable thought raced through my head from good to bad.  I had nightmares, migraine headaches, and an overall feeling of not wanting to get out of bed in the morning.  We made our way back to Lankenau Hospital for the follow-up 24 week ultrasound.  We were scheduled to see a pediatric cardiologist named Dr. Bhat for a fetal echocardiogram which would hopefully give us some more definitive answers as to what was wrong with our baby's heart.  Many of the details of this day are a blur to me as I think I may have subconciously blocked them from my memory.  I do remember Dr. Bhat coming in the room and conducting his own detailed scan of our baby's heart structures.  It must have gone on for 20 minutes or more, and included lots of color flow doppler, actual sounds of the heart beating, and many measurements.  Finally it was done!  Dr. Bhat told us he would speak with us in his office. 
  We sat down and he proceeded to draw us the most detailed diagram of a heart I have ever seen.  He told us that what he can see at this point in time is a moderate sized VSD (ventricular septal defect), a coarctation of the aorta, and an underdeveloped left ventricle of the heart.  Each of these anomalies in themselves can cause problems to the fetus.  He also informed us that until our baby was born and we were able to have an echocardiogram performed in the NICU, we would not know for sure what the specific defect or syndrome was.  My heart sank even further........ Best case scenario for the baby would be that the left ventricle continues to increase in size and is able to function and we are only looking at a VSD repair and/or ballooning of the aortic arch.  Worst case scenario would be that the left ventricle of the heart is not viable, and the baby would be diagnosed with a condition called Hypoplastic Left Heart Syndrome. 
  The doctor then informed us that our course of action at this point would be to follow-up regularly with fetal cardiology experts at A.I. Dupont Children's Hospital.  My mind was racing faster than I could even comprehend what he was saying.  I had been doing my research for the past 5 weeks, and I knew that the Philadelphia area was extremely blessed to offer some of the best options in cardiac care for children.  I also knew that if we were forced to endure this follow-up, I wanted it to be at The Children's Hospital of Philadelphia (CHOP).  I nicely told the doctor that we were interested in receiving our follow-up care at CHOP at which time I was referred to the Fetal Heart Program and Dr. Jack Rychik.
  In the next several weeks we made our first visit to CHOP and were introduced to Denise Donoghue, program coordinator as well as Dr. Rychik.  We had a follow-up fetal echo and then sat down with Dr. Rychik for a consultation.  For the most part he echoed the sentiments of what Dr. Bhat had told us back at Lankenau.  He showed us detailed computer images of our developing baby's heart, discussed the Cardiac Center at CHOP, and answered the 10-15 questions we had come prepared to ask.  Finally, he said to us that there are always options.  Our options at this point included terminating the pregnancy, bringing the baby home after delivery with supportive care and no medical intervention, OR our last option..... the three-staged surgical repair which if our baby was diagnosed with HLHS would be her only chance at life..........
TO BE CONTINUED....................