>> 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.
