homebirth and VSD/heart defect?

[audreyhorne]

i'm wondering if any of you mamas have had babies with a VSD(ventricular septal defect) or other congenital heart defects born at home? i'm 32 weeks pregnant with my 4th, and a VSD was confirmed with a fetal echo at 26 weeks.( i had an U/S to rule out a possible placenta problem) i was told by the neonatal cardiologist that even if i gave birth in a hospital, my baby wouldn't been seen as an emergent case and whisked away for testing, etc and would likely be seen by a cardiologist within the first 24 hours or so, so i'm feeling like it would be a safe bet to plan on an appointment with our ped within 24 hours and potential follow-up with a card soon after, but i'd love to hear from folks who've BTDT. i understand that most VSDs aren't diagnosed until after birth, so i imagine it's more common to have a home-born baby with a VSD than everyone is making me feel. 

[mommato5]

VSD can be minor. It can also be very serious depending upon how large the hole is. I would urge you to reconsider so that your baby can be born with professionals there and ready to examine it. They may need to get in an ultrasound shortly after birth so they can get a better picture of what is going on and what the next step should be in the baby's treatment/management.

[HariB]

 Haven't been there--but I'd still listen to a neonatal cardiologist over anyone else on this one--as far as him saying that it wouldn't be seen as 'emergent'.  At least I would if my mw was well-able to track baby's heart through labor, and in the early hours following birth.  A peaceful birth with no unnecessary interventions or other stressors has got to be the best thing for a baby who after all, is far more likely to have a relatively small defect, than a large one.  Heart defects are actually fairly common--I did a study on this a couple years back when a friend was told the same thing-- and read that 1 in about 125 babies has one.  Only rarely are they emergent situations...and many are so minor that they require no surgery, the defect fixes itself over the first year or so.  I didn't save any links but it was easy enough to search 'fetal heart defects' and find plenty of info from various sources. 

[mommato5]

Some do not correct themselves. Some children need surgery to fix them. This defect can be deadly. This defect can affect oxygenation of the blood. Minor infections can cause endocarditis, an infection of the heart. Anything that stresses the heart out can harm the heart, and this defect makes it all the more likely.

Hi, I'm a mom to a 12 year old boy who has VSD! It was suppose to close within a few months, then I was told he would die, then it should close in a few years, then it was by the time he's a teen, and now he's going to have surgery when we take that step.

[audreyhorne]

thatnks for your imput, mamato5. i'm wondering if anything was done to/for your son at birth, and when the VSD was discovered? we have been seeing cardiologists at CHOP in philadelphia, and we have been told that VSD is not something that is usually diagnosed at birth, but usually at a well-baby check up, and that it's only a fluke that it was caught on an U/S in the first place. we have been warned to watch for difficulty gaining weight, sleepiness and sweating while nursing, but that prenatal care/birth and post-partum should be textbook. threre have been no indications that would lead us to believe that having a potentially stressful, intervention-filled, disconnected birth would benefit the baby at all, and we discussed homebirth with our card. we've also been warned there is a possibility of open-heart surgury within the the baby's first year if the situation proves emergent, but we won't know until the time comes. please share your experience, because i'd love to have some information to bring back to them at our next visit. thanks.

[HariB]

So...what you are saying is that your son's VSD did not impact his birth, or the immediate postpartum time, right? 

Originally Posted by mommato5 

Some do not correct themselves. Some children need surgery to fix them. This defect can be deadly. This defect can affect oxygenation of the blood. Minor infections can cause endocarditis, an infection of the heart. Anything that stresses the heart out can harm the heart, and this defect makes it all the more likely.

Hi, I'm a mom to a 12 year old boy who has VSD! It was suppose to close within a few months, then I was told he would die, then it should close in a few years, then it was by the time he's a teen, and now he's going to have surgery when we take that step.

[mommato5]

We have to have regular monitoring. It was diagnosed upon birth. Luckily it is small, so we haven't had problems (knock on wood, but the fear is always there). If it was larger, then it would be a bigger issue than it is. He was a NICU baby, had to be resuscitated after being born blue and limp. He was almost a c-section baby because he was going into distress.

[HariB]

Just wondering...because I know a few people who've dealt with this defect and had no problems at all, at birth...just wondering if his distress could be traced directly to his VSD, or might have been caused by other things like cord issues, medications of birth, positioning, whatever else.  I mean, no disrespect intended at all--it's an honest question.  Quite a few hospital born babies and even some homeborn babies have distress during birth--even though they have no underlying heart or other defects.  Was it clear that his VSD impacted his birth, and his need for special care after?

[windymama]

If your pedi cardi and MW are fine with you having the baby at home and if you and your DP are both on board then it's your decision for a HB or not.  Where I live heart defects are automatic referrals to maternal-fetal-medicine specialists and out of MW care.

Things to consider - often times heart defects go hand in hand with other chromosonal abnormalites and/or birth defects. The size of the VSD will play a factor in your LOs health too. 

My DD has an AVSD so we were referred to the MFM specialists and had to deliver at a hospital with a level III NICU.  It was a good hospital birth, the only medicine was ABX and we had our hour of bonding before she went to NICU.  She was born in the wee hours of the morning and by late afternoon had had her first echo outside the womb.  From a cardiac stand point she was healthy but she wasn't gaining weight well so she had to stay in NICU for 5 days.  Real signs of congestive heart faliure started around the 2 week mark - which is normal for her condition.