Children's Hospital Colorado

Fetal Cardiology Telemedicine

For many patients who live in rural area and have need for specialized medical care, receiving regular and timely visits with a specialist can be an extraordinary and expensive burden. One potential solution to this issue is the use of telemedicine, allowing medical information to be exchanged between medical sites via electronic communications in order to improve a patient’s clinical health status. This innovative approach to medical care began expanding at Children’s Hospital Colorado approximately 4 years ago, with an increasing number of specialties now offering telemedicine care options.

Telemedicine has the potential to save patients time and money, and to decrease the amount of time missed from work to attend screening interventions. Children's Hospital Colorado currently conducts a fetal echocardiography telemedicine clinic in collaboration with St. Mary's Medical Center in Grand Junction, CO. This service provides critical access to fetal cardiac care and overcomes geographic separation between patients and university-based tertiary centers. Pregnant mothers from the western slope are referred to the fetal echocardiography telemedicine clinic at St. Mary's when concern arises that their unborn baby may have congenital heart disease. Prenatal diagnosis of congenital heart disease can increase survival as newborns with congenital heart defects may be clinically unstable at birth. Prior to telemedicine, families had to travel over the mountains to Denver for this service and timely diagnostic information.

We feel certain that our telemedicine program benefits not only patients and their babies, but also Children’s Hospital Colorado and its partnerships with referring communities. We currently have a research study examining whether tertiary-level diagnosis can be made through 1) telemedicine; 2) patient satisfaction with the service; 3) referring physician satisfaction; 4) impact of use of telemedicine regarding transfers avoided; 4) cost and time savings comparison for patient's regarding time and travel savings.

We hope that our collaboration with St. Mary’s will inform us about how to better serve mothers who need this screening. The effort has the capacity to be scaled to other interventions that might increase access to care lower costs of care, improved quality of care and improve patient outcomes.

We are transforming fetal cardiology through education

Recognizing CHD before birth can improve both prenatal and postnatal outcomes. Certain pregnancies are known to be at high risk for CHD, yet most cardiac defects occur in low risk pregnancies. Thus, one way to improve the outcome of fetal CHD is to improve prenatal detection of CHD in both high and low-risk pregnancies.

At Children’s Hospital Colorado, we offer a unique fetal echocardiography preceptorship program which is a 2-day apprenticeship created for health care providers interested in improving their skills in the diagnosis, treatment and understanding of fetal CHD. The program is given twice a year and is taught by our fetal cardiology sonographers and physicians from Children’s Hospital Colorado and The University of Colorado. The class is limited to 20 students to encourage group interaction. The overreaching goal of the program is for obstetrical sonographers and physicians to detect more fetal CHD earlier in pregnancy, so affected babies can deliver at a cardiac center of excellence and receive the necessary critical care. We appreciate that learning is a lifelong process! We are happy to give a second opinion or help our students with perplexing cases. For more information about the preceptorship, contact Shari Borcherding at shari.borcherding@childrenscolorado.org or call 720-777-2944.

We are transforming Fetal Cardiology through innovative research

Our fetal cardiology team together with the maternal, perinatal and neonatal experts at Children’s Hospital Colorado continually strives to improve patient outcomes and advance the science of fetal cardiology. Our research includes primary fetal cardiac issues as well as non-cardiac anomalies that impact the fetal cardiovascular system. We are the leader in several national and international multicenter studies, and a participating center in several others. Through our research program, we are gaining insight into the causes of fetal cardiac conditions and developing strategies for novel treatments. A complete list of current studies may be found below.

Research Projects on Primary Fetal Cardiac Anomalies           

  • Pregnancy and Long QT Syndrome
  • Heart Sounds at Home: Prospective Maternal Surveillance of SSA Positive Pregnancies Using a Hand-Held Fetal Heart Rate Monitor
  • Outcomes of Pulmonary Atresia and Intact Ventricular Septum
  • Effect of dexamethasone on outcome of fetus with immune-mediated AV block
  • Treatment of Fetal Atrial flutter & Supraventricular Tachycardia (FAST Therapy Trial)
  • Healing from a distance: results of a rural Fetal Cardiology Telemedicine program
  • Database of Normal Values of Cardiac Anatomy and Function, Cardiac Rhythm, and Cardiac Mechanics in Fetuses by Echocardiogram.
  • International Fetal Cardiac Intervention Registry

Research Projects on Secondary Fetal Cardiac Anomalies

  • Left ventricular sphericity index in fetuses with congenital diaphragmatic hernia
  • Assessment of fetal cardiac function in Twin-Twin Transfusion Syndrome
  • Effect of indomethacin and anesthetic regimen on the fetal heart during open myelomeningocele repair
  • Bladder outlet obstruction and cardiac function
  • Evaluation of heart function in the fetus at risk for heart failure using Velocity Vector Imaging (VVI)

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