Children's National Health System

Cardiac Imaging Fellowship, and Co-director of the Cardiac Neurodevelopmental Outcome Program at Children's National. "Due to advances in ultrasound, we can visualize the heart and make the diagnosis of severe congenital heart disease as early as 12 weeks. I developed the Early Cardiac Imaging Program with the primary goal of making a diagnosis early in pregnancy. In situations when the heart is normal, families are comforted and stress is reduced. If a congenital heart defect is identified, this allows families and physicians greater time to come to terms with the diagnosis and develop a management plan." Depending on the severity of the congenital defect, whether involving the heart or another part of the body, Dr. Donofrio and the Children's National Critical Care Delivery team use specialized protocols of delivery risk stratification to determine the safest plan for delivery so that the appropriate care can begin immediately at birth. AT THE FOREFRONT OF MEDICINE Children with congenital heart defects typically encounter developmental challenges as they mature. The Advanced Pediatric Brain Imaging Research Laboratory is leading a National Institutes of Health Research Project Grant-sponsored study to better determine the timing and onset of brain growth disturbances, which can guide early medical and surgical interventions. "We originally attributed developmental disabilities in newborns who had open-heart surgery to correct a congenital heart defect to events that happened at or around the time of surgery," says Catherine Limperopoulos, PhD, Director of the Advanced Pediatric Brain Imaging Research Laboratory and Director of MRI Research of the Developing Brain at Children's National. "A recent seminal study, however, revealed that impaired brain growth and metabolism can be reliably identified during the third trimester of pregnancy. In the current study, we hope to understand why these disturbances occur and use MRI to monitor fetuses with heart disease that may be amenable to in utero intervention." Research also is ongoing in the areas of prematurity-related brain damage and disturbances in brain development in fetuses experiencing growth challenges. The end goal is to use fetal brain injury risk to make more informed decisions about the timing and mode of delivery. To make a referral to the Children's National Fetal Medicine Institute, call the referral line at 202-476-7409. Fetal Care FETAL MEDICINE 11

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