Rare Congenital Heart Defect Diagnosed by Access TeleCare’s Advanced Practice Sonography Team and MFM Specialists

Access TeleCare Case Study

Addressing Complex Patient Care Needs Through Telemedicine

The Case

A pregnant patient presented at a Colorado birth center for an anatomy scan. The local sonography team marked the scan as “normal/suboptimal” and requested a second interpretation by the Access TeleCare advanced practice sonography (APS) team. After review, the APS team identified a rare congenital heart defect that had been overlooked by the local sonographer. The case status was immediately upgraded to “STAT,” prompting a review of the finding by the consulting Access TeleCare maternal-fetal medicine specialist. Within minutes of the diagnosis, the Access TeleCare MFM specialist was consulting directly with the patient’s obstetrician to review the serious findings and discuss next steps.

The cardiac defect identified was a double outlet right ventricle with ventricular septal defect and pulmonary atresia. It requires surgery to correct and a team of pediatric cardiologists and cardiac surgeons, neonatologists, and MFM specialists to monitor and manage prenatal care, delivery, and postnatal care.

The Care Plan

After detection of the defect by the APS team, Access TeleCare’s maternal-fetal medicine specialist quickly consulted with the patient’s obstetrician to discuss next steps including further ultrasound exams, obtaining necessary consults, and guidance for the delivery plan. If a fetus delivers with an undiagnosed cyanotic heart lesion, particularly in a birthing center, the outcomes typically are very poor.

“Effective and early diagnosis of critical fetal and maternal issues is paramount to optimizing outcomes for both moms and their babies. Access TeleCare’s highly skilled, highly experienced sonographers and specialists work as a team to improve pregnancy outcomes.”

– Blake Porter, M.D. | Access TeleCare Chief of Maternal-Fetal Medicine

The Result

With detection of a serious defect in utero before delivery, the patient could make an informed decision about where to deliver in a location that is prepared, equipped, and staffed for the condition. The care team avoided both delivery at the local hospital that likely would not have been prepared for the emergent condition and emergent transfer of a potentially unstable newborn.

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Peace of Mind for Providers and Patients

Access TeleCare’s teleMaternal-fetal medicine specialists consistently identify abnormalities in 7 percent of ultrasounds deemed “normal” by local sonographers and obstetricians.

Our team-based approach to care of pregnant patients includes both board-certified maternal-fetal medicine specialists and highly trained and experienced sonographers, all of whom are Registered Diagnostic Medical Sonographers (RDMS), with more than 40 years of experience in reading sonograms.

Our team of virtual sonographers work closely with on-site sonographers on how to get high-quality images in fetal scans and provide on-going training on best practices with using video clips and achieving the standard of care.