>> THE CARDIAC CENTER AT THE CHILDREN'S HOSPITAL
OF PHILADELPHIA WAS CREATED IN ABOUT 1997 AS A WAY
OF BRINGING TOGETHER ALL OF THE AREAS OF SPECIALTY DEALING
WITH CHILDREN WITH CONGENITAL HEART DEFECTS.
>> WE AS A CENTER HAVE THE PRIVILEGE TO TAKE CARE
OF A VERY LARGE NUMBER OF PATIENTS
WITH CONGENITAL HEART DISEASE.
WE HAVE FAMILIES COMING INTO THIS REALLY COMPLEX
CONTINUUM OF CARE, AND WE WEREN'T BEGINNING
IT EARLY ENOUGH.
WE WERE STARTING IT WHEN THEY CAME TO
THE INTENSIVE CARE UNIT.
>> AND THAT'S WHERE WE COME IN WITH
THE FETAL HEART PROGRAM.
OUR OBJECTIVE IS TO MAKE THESE DIAGNOSES OF HEART
DISEASE AS EARLY AS POSSIBLE.
>> TO ASSESS THE FETAL HEART,
THE FUNCTION, THE STRUCTURES--
>> TO PROVIDE INFORMATION TO THESE FAMILIES--
>> AND TO HAVE THEM AVAIL THEMSELVES OF ALL THE OTHER
RESOURCES THAT WE WANT THEM TO MEET.
>> SO WHEN THEY DO COME TO THE TIME WHERE THEY'RE GOING
TO DELIVER, THEY CAN STILL CELEBRATE THE BIRTH OF THEIR
CHILD AND ALSO KNOW THAT THAT CHILD IS GOING TO BE
CARED FOR IN THE BEST WAY POSSIBLE.
>> IT'S DEVASTATING FOR FAMILIES TO LEARN THAT THEY
ARE CARRYING A BABY THAT HAS CONGENITAL HEART DISEASE.
THIS IMPACTS THE WAY THEY ENVISION THE FUTURE.
>> AND HERE, WITH THIS DEVASTATING NEWS
OF REALIZING THAT THERE'S A BIRTH DEFECT OF THE HEART
IN THEIR FETUS, ALL OF THAT COMES SHATTERING DOWN.
>> YOU'RE STUNNED, YOU KNOW.
YOU'RE SHOCKED.
>> THE WORD REALLY IS SHOCKING.
IT WAS JUST IMPOSSIBLE TO BELIEVE.
>> YOU'RE SITTING THERE GOING, "WHAT?"
>> WHAT DO YOU MEAN THERE'S SOMETHING WRONG
WITH MY CHILD?
>> WE FELT SO HELPLESS AND OVERWHELMING.
IT WAS VERY SCARY.
>> WE IDENTIFIED THAT FAMILIES WHO KNEW ABOUT
A CHILD WITH A CONGENITAL HEART DEFECT IN ADVANCE,
BEFORE DELIVERY, FIRST, HAD THE ABILITY TO GET MORE
INFORMATION AND BE MORE COMFORTABLE ABOUT THEIR
CHILD, BUT IN ADDITION, WOULD ENABLE US TO HAVE
THESE CHILDREN COME IN AND BE STABILIZED BETTER BEFORE
THEIR SURGICAL PROCEDURE OR THEIR OTHER INTERVENTION
THAT IS NECESSARY FOR THEIR HEART DEFECT.
>> WE RECOGNIZE THAT HEART DISEASE DOESN'T START
AT BIRTH.
IN MOST OF THESE CIRCUMSTANCES,
IT STARTS IN THE DEVELOPING FETUS.
AND SO THE CONCEPT OF A FETAL HEART PROGRAM IS
THE IDEA OF TRYING TO DIAGNOSE THE PROBLEM BEFORE A CHILD
IS BORN, AND THEN AT VERY LEAST YOU CAN PREPARE
PARENTS FOR WHAT THEY'RE GOING TO FACE.
>> NOW WE CAN LOOK AT THE FETUS AT A VERY YOUNG AGE
AND BE ABLE TO DIAGNOSE WHEN THERE'S A PROBLEM
AND THEN BE ABLE TO TRACK THAT FETUS THROUGHOUT PREGNANCY.
>> WE INTRODUCED THE FETAL HEART PROGRAM AT CHILDREN'S
HOSPITAL IN MAY OF 2001, SO IT'S REALLY NOT THAT OLD.
AND EVEN THAT'S COME A LONG WAY.
>> FROM JUST BEING ABLE TO DIAGNOSE HEART DISEASE
BEFORE THE BABY IS BORN TO ACTUALLY BEING A PROGRAM
THAT CAN SUPPORT PARENTS WITH EDUCATION
AND EXPECTATIONS.
>> WE PROVIDE A COMPLETE EDUCATIONAL PROCESS,
COMPLETE EDUCATIONAL EXPERIENCE.
>> TO PLAN WITH THAT FAMILY THE REMAINDER OF THE WOMAN'S
PREGNANCY, ALL THE WAY THROUGH TO DELIVERY
AND POSTNATAL CARE OF THE BABY.
>> THE EARLIER YOU CAN MAKE THIS DIAGNOSIS THE BETTER
IS THE OUTCOME GOING TO BE FOR THESE FAMILIES.
>> A LOT OF BABIES THAT AREN'T DIAGNOSED EARLY, LIKE
WE WERE, ACTUALLY HAVE A LOT OF PROBLEMS BECAUSE THEY
THINK THE BABY IS OK, AND THEY GO HOME,
AND THEY START HAVING-- THEY START TURNING BLUE,
RIGHT, AND THEN THE BABY IS UNDER STRESS.
AND THEN THEY BRING THEM BACK,
AND IT'S ACTUALLY A VERY DIFFICULT OPERATION
AT THAT POINT.
>> THE BEAUTY OF THE FETAL PROGRAM IS THAT
THE DIAGNOSIS IS MADE IN ADVANCE.
THE PARENTS HAVE AN EXPECTATION ABOUT WHAT'S
GOING TO HAPPEN, AND WE CAN KEEP THE BABY
FROM GETTING SICK.
SO YOU HAVE A MUCH BETTER PATIENT GOING
TO THE OPERATING ROOM FOR THEIR SURGERY.