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Last Updated: Sunday, 23 July 2006, 02:49 GMT 03:49 UK
Inside medicine: Foetal cardiac nurse
Mary in her office
Mary helps support families whose babies have heart problems
In a series on medical specialisms, the BBC News website meets Mary McLaughlin, who talks about being a foetal cardiac nurse at the Royal Brompton and Harefield NHS Trust in London.

Foetal cardiology involves the care of heart health for a foetus in the womb and a newborn baby.

What is your job?

My role as a foetal cardiac nurse specialist is to provide relevant and accurate information to families whose unborn babies are diagnosed with congenital heart disease.

I advise families and support them in making informed decisions about the pre-natal care of their pregnancy, through to the birth and post-natal care of their baby.

I work in busy specialist clinics, working alongside some the of the world's leading foetal cardiologists.

I'm also involved in developing strong links with other professionals, including GPs and midwives in local maternity centres.

I provide specialist training and expertise to them so they can help support mothers who need access to specialist cardiac care for their unborn child.

What is the most common condition?

Congenital heart disease (CHD) is the most common cause of childhood death among all congenital defects.

It is distressing to see these families struggling with their grief and often there is little I can do to ease their pain
Mary McLaughlin

Today in the UK, over 6,000 babies are born with heart disease every year.

The most common heart defects include babies born with holes in the heart and 'blue' babies, where the two main arteries are the wrong way round.

'Blue' babies need corrective surgery within the first few weeks of being born.

More serious conditions include 'Tetralogy of Fallot' where the baby is born with a combination of a hole in the heart, narrowing of the lung artery and a displacement of the main artery, which transports blood around the body.

These babies will need corrective surgery when they are six to nine months old.

What is the most common procedure?

The most common procedure is a foetal echo - a scan - that shows the four chambers of the baby's heart. 

We look to see how the heart is developing and look at how the blood flows around it. 

This is normally carried out at 20 weeks, but at RB&H we can do this as early as 13 weeks. 

There are many reasons why mothers are referred to us for a foetal scan but the main reasons are if one of the parents has a congenital heart abnormality or there is a family history of congenital heart disease, or if there is an increase in the fluid at the back of the baby's neck - as this can suggest a possible heart problem.

The hardest thing about your job?

It is devastating for a family to learn that their baby has a heart problem, no matter how big or small the defect may be.

I see these families at their most vulnerable.

In the more severe cases of congenital heart disease, I support parents in making a decision as to whether they wish to continue with the pregnancy.

There are some situations where the pregnancy may not successfully reach its full term or the baby may not survive surgery.

It is distressing to see these families struggling with their grief and often there is little I can do to ease their pain.

The most satisfying case?

I enjoy developing a trusted, professional relationship with families, from an early stage in the mother's pregnancy.

Although families are at their most vulnerable, struggling to come to terms with the knowledge that their baby has a heart problem that may need surgery, it is very satisfying to see them leave hospital with a healthy baby whose heart has been treated.

Then they can begin to enjoy their life with their baby.

Most families like to maintain contact after they go and often I will see them through another pregnancies when an early foetal scan can be performed to rule out congenital heart disease in the new baby.

Why did you choose this specialty?

As a children's nurse, a large part of my career has been spent in paediatric cardiology.

As modern medicine has progressed so has the outcome of treatment of congenital heart disease.

Improvements in medical and surgical treatment over the last few decades have led to more than 85% of babies born with heart disease surviving into adulthood.

As a children's cardiac nurse specialist, I saw the need to develop the role into foetal cardiology, as this is a new but rapidly developing service.

I was lucky enough to be given the opportunity to develop this service at the Royal Brompton and Harefield and have found it a necessary and very fulfilling role.

If you had you time again would you change your speciality?

No. Working in this speciality has enabled me to develop a strong knowledge-base and expertise.

I thoroughly enjoy my job, however it can get stressful at times.

I love the variety with my job and have great job satisfaction.

How do you see the role developing in the future?

With improvements in foetal screening and training of sonographers, the prenatal diagnosis and care given to families will increase and help develop our specialist services further.

As with any job, working as a team is crucial and specialist nurses are but one part of the jigsaw.

Leading a team and training other staff will develop and widen the support myself and others can offer families.

CV - Mary McLaughlin
1981: Qualified as a registered children's nurse
1994:Qualified as a health visitor
2000: Started working in paediatric cardiology
2002:Began specialising in foetal cardiology



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