Supervisor: Lisa Hornberger
Project: Investigating the accuracy of fetal echocardiography in the diagnosis of heart defects before birth
Bachelor of Science in Honours Physiology
Why did you choose this program?
Human physiology has always interested me. I was fascinated in high school by the elegance of each organ system, both in its independent function, but also in the interdependence. This program provides the opportunity for me to delve deeper—from all the intricate details of the cellular level to the tissues to the organs—and all the biological processes that occur in us so naturally, that we do not give a second thought!
What's been the best part of your experience so far?
I learned so much this summer about the research process and fetal cardiology, which has intrigued me to explore the field more. I enjoyed getting an overview of patient care through my project—from gaining exposure to fetal echo images, to noting down the diagnosis and counseling through the report, to reading about the patient's outcome and surgical interventions after delivery. A definite highlight was attending the weekly surgical conference and seeing the multidisciplinary aspect; it was inspiring listening to passionate surgeons and pediatric cardiologists discuss the best route of care for the patient.
What interested you in the summer studentship program?
It was an unique opportunity for me to pursue and learn more about the intriguing world of research. I was excited to work under Dr. Hornberger, given her expertise in the fetal cardiology field and experience in supervising trainees and students—she was an invaluable mentor! This experience allowed me to become better equipped for the research requirements of my degree program, as well as become one step closer to my career aspirations.
How has your studentship helped you towards your career aspirations?
As an undergraduate student aspiring to be an academic physician engaged in research, this studentship allowed me to have a glimpse of both sides of the coin. I enjoyed actively participating in the entirety of the research process—from topic conceptualization, data collection and statistical analysis, to writing an abstract and a paper—while also gaining a glimpse of a physician's responsibilities. This experience allowed me to become adept with the process of clinical research and further enhance my critical thinking, analytical and problem solving skills, which are particularly indispensable for the medical profession.
What has the support from WCHRI, the Stollery Children's Hospital Foundation and the Alberta Women's Health Foundation meant to you?
I'm incredibly grateful for the support of Stollery Children's Hospital Foundation and the Alberta Women's Health Foundation through WCHRI, which has allowed me to fully pursue research this summer. It has allowed me to focus on developing my research skills and publish findings with the hopes that the best possible patient counseling and care can be provided. It was an eye-opening experience both into medicine and into research.
Fetal echocardiography—the use of ultrasound or sound waves to image a baby's heart while in the mother's womb—is a critical tool in allowing the detection and diagnosis of structural congenital heart defects (CHD) before birth. A diagnosis of CHD before birth has been shown to lead to improved care of the pregnant mother, with the baby being delivered in the best place for care and at the best time. However, there have been very few studies that have examined the accuracy of fetal echocardiography, which is key to ensuring the counseling is accurate and the care of the pregnancy and newborn is the best it can be.
This project will examine the accuracy of fetal echocardiography in defining the anatomy of CHD before birth with comparison to findings in the babies after birth by echo, at surgery and/or at autopsy. We will be reviewing 12 different CHD subtypes including over 500 cases diagnosed before birth within the University of Alberta's Fetal and Neonatal Cardiology Program between 2004 and 2017.
Differences between diagnoses made before and after birth will be categorized based on the importance of the differences between the before and after birth findings: 1) no difference, 2) minor difference with no impact on clinical outcome 3) difference that has a minor impact on surgical care, 4) major differences which impacts the acute care and surgical outcomes of the baby and 5) differences in category that could impact counseling around associated conditions.
We will also explore other factors that impact accuracy in defining anatomy including CHD subtypes and anatomical elements that are more difficult to evaluate before birth, the year of assessment and serial assessments before birth. We hypothesize that the accuracy of fetal echocardiography is relatively high, has increased over the years, and that serial assessments improve diagnostic accuracy. Through potentially identifying modifiable factors to enhance our assessments, we hope to improve the care of affected babies.