Timely Emergency Response Saves a 35-Week Fetus with Patent Foramen Ovale Abnormality

At 32 weeks of pregnancy, an abnormality in the patent foramen ovale (PFO) was detected in expectant mother Đ.P.A. With close monitoring by the Obstetrics and Pediatrics Cardiology teams, her baby was safely delivered at 35 weeks and 3 days.

Opting to monitor her pregnancy at Hanoi French Hospital (HFH) from 26 weeks, Ms. P.A. received thorough care from Dr. Hồ Văn Thu, Head of the Department of Obstetrics and Gynecology. Both mother and baby were in good health during regular check-ups. However, at 32 weeks, an ultrasound revealed a protrusion in the atrial septum at the PFO site. Recognizing the potential danger, Dr. Thu immediately consulted with a pediatric cardiologist. A detailed fetal echocardiogram confirmed a small PFO with a high risk of early closure. The teams collaboratively devised a plan to keep the baby in the womb as long as safely possible while preparing for an optimal delivery.

Dr. Lê Ngọc Lan, a pediatrician specializing in cardiology who oversaw the case, explained:

"The PFO is a necessary opening between the right and left atria in the fetal heart, enabling circulation during gestation. Normally, the PFO remains open during pregnancy and closes naturally days to months after birth. However, a small PFO that closes prematurely in utero can pose severe risks, even endangering the fetus's life."

At 35 weeks and 3 days, signs of danger were detected via fetal echocardiogram. Following a multidisciplinary consultation, Dr. Thu decided on an emergency cesarean section. The baby was delivered on  time, but exhibited irregular breathing, pallor, an enlarged liver, and low oxygen saturation (SpO2: 75-80%). Immediate neonatal intensive care was initiated and, two days after delivery, the baby’s health stabilized. This finally allowed mother and baby to bond and be discharged on schedule together.

Interdisciplinary Approach in Risk Management During Pregnancy

Dr. Ngọc Lan emphasized that early closure of the PFO is a rare fetal abnormality with limited documentation in global medical literature. Its pathogenesis remains unclear, and it can occur at any stage of pregnancy. If not detected and managed early, it poses a high risk of perinatal mortality. The involvement of skilled imaging specialists and obstetricians is vital to identify this condition and formulate an optimal treatment strategy.

Dr. Nguyễn Trung Hà, Head of the Pediatrics Department, shared:

“Saving this baby underscores the relentless dedication of our team to make sure patient safety is prioritized. It requires seamless collaboration between multiple departments including Obstetrics, Pediatrics and specialists, starting from prenatal screening to delivery to postnatal support. Once we identify high-risk factors we have to create intricate, tailored plans with the ultimate goal of safeguarding both mother and baby. Our aim is always to provide the best foundation for the child’s future development.”