Transposition of the great vessels prevention


 * Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org]; ; Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

Overview
The development of a fetal heart starts during the first trimester of pregnancy. Thus, many a times the fetal heart has already developed, by the time the female becomes aware of being pregnant. There are some risk factors that if avoided before and during pregnancy can decrease the occurrence of congenital heart diseases.

Prevention
General

The development of a fetal heart starts during the first trimester of pregnancy. Thus, many a times the fetal heart has already developed, by the time the female becomes aware of being pregnant. Some steps taken before and during pregnancy that can help in preventing the congenital heart diseases are as follow-


 * All females planning for pregnancy should start taking folate (400micrograms/day). This is so because, the birth defects occur most commonly during first trimester of pregnancy even before the female is aware of being pregnant.
 * Avoid medications like lithium, anti-acne drugs (retinoic acid) and some anti-epileptic drugs.
 * Ensuring the female has proper immunity against Rubella (before getting pregnant).
 * Ensure proper and complete treatment of upper respiratory tract infections.
 * Avoid viral infections
 * Avoid intravenous drug abuse
 * Avoid alcohol
 * Avoid strong chemicals (solvents)
 * Avoid X-rays

Specific


 * Women with some diseases like diabetes, seizures etc should consult their physicians before and during pregnancy for special management strategies for these diseases to prevent the occurrence of congenital heart diseases.
 * Females with phenylketonuria may need to follow a special phenylketoneuric diet before pregnancy and during the first trimester.
 * Genetic counselling can be offered to parents who have previous history of a child with birth defect or with family history.