This case marks the youngest fetus in Vietnam to undergo in-utero heart defect repair. It is also the 15th fetal cardiac intervention performed collaboratively by Tu Du Hospital and Nhi Dong 1 Hospital in TP HCM.

The 26-year-old mother, from Hanoi, was in her third pregnancy. Nearing 24 weeks, an ultrasound revealed that the valve responsible for blood flow from the fetus's heart to its lungs was completely blocked. The expectant mother then sought treatment at Tu Du Hospital. At that time, the fetal right heart chamber was smaller than expected for its gestational age, another heart valve showed severe leakage, and no blood flowed through the blocked valve. Doctors determined that "further waiting was not an option," as continued shrinking of the heart chamber would make it difficult, if not impossible, to insert instruments for a successful cardiac procedure.

Doctors from Tu Du Hospital and Nhi Dong 1 Hospital convened for a consultation, also seeking advice from experts in Austria and Italy, ultimately deciding on an urgent intervention. On 26/8, five medical teams collaborated to perform the procedure. Guided by ultrasound, doctors carefully inserted a needle through the mother's abdomen and uterus, accessing the fetal heart to dilate the blocked valve. Immediately following the dilation, blood flow from the heart to the lungs was restored.

During the instrument withdrawal, the fetus experienced bleeding around the heart, leading to compression. Doctors promptly aspirated approximately 3 ml of blood to relieve the pressure, stabilizing the fetal heart rate and improving cardiac contractions. The intervention concluded two hours later. Four hours post-procedure, the mother was stable, without abdominal pain, uterine contractions, or bleeding. Blood flow through the fetal heart valve continued to be maintained.

Both hospitals are jointly monitoring the pregnancy. This in-utero valve opening procedure provides the heart with better conditions for development, increasing the baby's chances of using both heart chambers after birth.

The doctors performing fetal cardiac intervention at Tu Du Hospital, 26/8. Photo: Hospital provided

Tang Chi Thuong, Director of the Ho Chi Minh City Department of Health, commended the intervention, highlighting the effectiveness of connecting specialized departments. The Fetal Intervention Center at Tu Du Hospital collaborates with the Pediatric Cardiovascular Intervention Center at Nhi Dong 1 Hospital to treat patients even before birth.

According to Mr. Thuong, advanced medical care requires not only establishing centers of excellence in individual fields but also fostering connections to perform complex techniques, thereby expanding treatment opportunities for patients.

Fetal cardiac intervention represents a significant medical achievement for Vietnam, having been implemented since early 2024. To date, it has enabled many babies with congenital heart defects to be born safely. This highly specialized technique demands advanced skills and is currently performed in only a few locations worldwide. Last year, a Singaporean woman, pregnant for the first time after more than 10 years of infertility, was referred to Vietnam for her child's cardiac procedure, subsequently returning home to deliver a healthy baby.

Le Phuong