The blue baby syndrome

  • By Dr. Arijit Ghosh
  1. Causes:

    It is caused by a group of birth defects of heart known as congenital heart diseases. Most patients have structural defects in heart that prevents proper oxygenation of blood. Improperly oxygenated blood reaches skin surface to cause bluish discoloration. Important causes of blue baby syndrome are as follows:

  2. Tetralogy of Fallot:

    It is a birth defect of heart that prevents proper oxygenation of blood and inhibits supply of the oxygenated blood to the different areas of the body including skin. The defects consist of improper positioning of aorta, narrow aortic valve, a hole in the wall separating left and right ventricles and enlargement of the right lower chamber of the heart known as right ventricle. Patients with Tetralogy of Fallot have bluish discoloration of skin since birth and condition of the newborn worsens gradually.

  3. Transposition of great arteries:

    In this condition, two large arteries arising from the heart interchange their position. As a result, deoxygenated blood goes the different parts of the body instead of going to the lungs and as a result, the child appears blue.

  4. Truncus Arteriosus:

    It a rare birth defect of heart. The heart contains one large artery that carries both oxygenated and deoxygenated blood. As a result the child appears with bluish discoloration.

Signs and symptoms:

The signs and symptoms are as follows:

  1. Cyanosis:

    The bluish discoloration of skin, lips, and fingernails is known as cyanosis. It is further accompanied by difficulty in breathing, lack of energy and decreased mental alertness. The trouble with breathing increases gradually, the infant may become less alert, shows lack of energy and may become unconscious.

  2. Delayed development:

    Lacks of oxygenation leads to failure to thrive. The infant will not grow at the same rate as a healthy infant.

  3. Diagnosis:

    The provisional diagnosis is made by the doctor initially with the help ofthe clinical examinations. The bluish discoloration of skin, lips, and fingertips gives a fair idea to the doctor regarding possibility of birth defects in heart. The diagnosis is further confirmed by the imaging investigations like echocardiography, x-rays, etc.

  4. Treatment:

    Prompt diagnosis and early treatment are the keys to cure. Once the diagnosis is established the doctor evaluates possible causes and assesses the severity symptoms. The definitive treatment is surgery. Before initiation of surgery, the newborn is prescribed drug therapy to make him or her fit for surgery. During the drug therapy, the child is monitored very closely. It is followed by open heart surgery for definitive cure. The surgical procedure is known as Block-Taussig shunt and as a result blood circulating in the different parts of the body becomes oxygenated.

  5. Prevention:

    Few procedures are available to detect congenital heart defect in developing baby of pregnant mother. Most common tests are diagnostic ultrasound, fetal echocardiography adopted during pregnancy to detect birth defects in heart of the fetus.