How to prevent having babies with heart deformities

No one prays to have a baby that is born with deformity of any kind, even if it can later be corrected through surgical operation. However, steps to prevent any infection before a pregnancy, which can lead to a woman having a deformed child, such as a bad heart, must be taken, reports Sade Oguntola.

Steps taken to ensure wellness before getting pregnant may help reduce cases of children with heart anomaly. Experts say that pregnant women who have urinary tract infections (UTI) without ensuring this is treated appropriately before conception stand the risk of giving birth to babies with heart anomaly, according to a US study.

According to them, pregnant women who had a urinary tract infection(UTI) from one month before conception through the first trimester of pregnancy(three months of pregnancy) were 70 per cent more likely than women without UTI to have a baby with at least one heart abnormality. One of such abnormalities is hypoplastic left heart syndrome (HLHS), a situation where the left side of the heart is underdeveloped.

Urinary tract infections are a serious health problem affecting millions of people each year worldwide. They are the second most common type of infection in the body. Experts say women are especially prone to UTIs for reasons that are not yet fully understood. In fact, one woman in five develops a UTI during her lifetime.

UTIs in men are not as common as in women but can be very serious when they do occur. Nevertheless, not everyone with a UTI has symptoms. Its common symptoms include a frequent urge to urinate and a painful, burning feeling when urinating.

The researchers came to this conclusion after assessing urinary tract bacteriuria in 3,690 women who had infants with “nonsyndromic” congenital heart defects, and 4,760 mothers of infants without heart defects.

Mario Cleves of the University of Arkansas for Medical Sciences, Little Rock, USA and team found that women who had infants with HLHS were 1.7 times more likely than mothers with healthy children to report having had a UTI at some point during pregnancy.

In fact , mother’s age , race, vitamin use, folic acid intake, ethnicity, exposure to sulfonamide drugs or even exposure of such babies while yet in the womb to adverse environmental factors such as alcohol had no effect on determining which baby may end up having HLHS, indicating that UTI diagnosis was an independent predictor.

Much as birth defects may involve many different organs including the brain, heart, lungs, liver, bones, and intestinal tract, these defects can occur for many reasons including inherited (genetic) conditions, toxic exposure of the unborn baby (for example, to alcohol), birth injury and, in many cases, for unknown reasons. All parents are at risk of having a baby with a birth defect, regardless of age, race, income or residence.

How a particular birth defect affects a child varies and depends greatly on the severity of the defect and whether or not other medical problems are present. The study author, Sadia Malik, of the University of Arkansas Medical School in Little Rock, said this further emphasised the need for detecting and treating bacteriuria that does not give any symptom and UTI in women at time of conception. According to the expert, doing this may decrease the risk of having an infant with this type of heart problem.

The investigators concluded: “Preconception detection and treatment of bacteriuria showing no symptom and UTI in women of reproductive age may decrease the risk of having an infant with a left-sided obstructive heart defect.”

In the explanation by Dr. Adetona Fayemiwo, a consultant microbiologist at University College Hospital (UCH), Ibadan, though normally, urine is sterile and an infection will only occur when tiny organisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. The urethra is the tube that carries urine from the bladder to outside the body.

He declared that most infections arise from one type of bacteria, Escherichia coli (E. coli), which normally lives in the colon. In many cases, bacteria first travel to the urethra. When bacteria multiply, an infection can occur. Though other microorganisms such as Chlamydia and Mycoplasma might cause UTIs, he said these are different unlike E. coli because they can be contracted through sex. Quite unlike what many people will think, he explained that UTIs is not commoner in pregnant women than in other women. “If you are not hygienic enough, you can have this infection. For instance, in a female the opening of the vagina is close to the anus and so if a woman does not clean properly, the micro-organisms in the feaces can make for the possibility of E. coli causing URI.

However, the expert said that when a UTI does occur in a pregnant woman, it is more likely to travel to the kidneys. This is because of hormonal changes and shifts in the position of the urinary tract during pregnancy, thus making it easier for bacteria to travel up the urethra to the kidneys.

According to him, some cases of URIs occur even before pregnancy, especially in newly weds because of frequent and vigorous sex and in some individuals with posterior urethra valve abnormalities. Nearly 20 per cent of women who have a UTI will have it reoccuring and those who have had three UTIs are likely to continue having them. Four out of every five of such women will get another within 18 months of the last UTI. Many women have them even more often.

However, a woman who has frequent recurrences (three or more in a year) can ask her doctor about appropriate treatment options Dr. Fayemiwo said URI may be a big problem and with severe complications such as septicaemia (an infection of the blood). Though other sexually transmitted infections like gonorrhoea and Chlamydia during childbirth can affect the baby causing eye problem and so on, he said the chances of URI causing heart abnormalities in a yet-to-be-born child is however remote.

“We know some organisms like streptococcus can lead to meningitis in a new born, syphilis can lead to syphilis in them as well as E.coli leading to UTI, thus progressing to malformation of, say, the heart. Dr. Kayode Afolabi, a consultant obstetrics and gynaecologist at the same hospital said this is one problem that finds its way into the urethral, the tube that carries urine from the bladder outside is very short and opens into the same orifice as the vagina, thereby making it possible to have cross infection between urinary tract and the reproductive. When such infection ascends the reproductive tube, it could also lead to tubal problems such as its blockage , malfunctioning or the destruction of the inner lining of the tube, so contributing to infertility in such a woman.

“In this environment, tubal problem is a major cause of female infertility problem. This infection makes them have burning sensation when urinating and sometimes pain in the lower abdomen. It may sometimes progress to pelvic inflammatory diseases, Dr Afolabi declared.

Normally, a UTI does not cause fever if it is in the bladder or urethra. Dr. Afolabi said that , by the time the woman starts to have fever, it might mean that the infection has spread to the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting. Doctors suggest that to help prevent a urinary tract infection, a woman should:

•Drink plenty of water every day.

•Urinate when you feel the need; do not resist the urge to urinate.

• Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra.

•Take showers instead of tub baths.

• Cleanse the genital area before sexual intercourse.

•Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.

•Keep the vaginal area clean, wiping from the front to back after a bowel movement to prevent contamination of the urinary tract.

• Use tampons and change every three to four hours, instead of sanitary pads. (The pads can act as a culture medium for faecal bacteria, which may then be rubbed against the urinary outlet and invade the bladder.)

• Wear cotton undergarments, which allow air circulation and discourage the warm, moist environment needed for bacteria growth. Nylon pantyhose should have a cotton crotch.

• Avoid wearing tight clothes in the genital area, such as control-top pantyhose and skin-tight jeans, as well as extended wearing of a wet bathing suit.

• Urinate before and after intercourse and make sure that the partner’s hands and penis are clean.