Beginning CHD Care Before Birth

Pediatric cardiology's rapidly evolving landscape is part of what Shelby White, MD, enjoys about her specialty. As part of the fetal cardiology team, she starts caring for children with CHD before they're born, using advanced techniques and research that continues to expand.

She shares more about why pediatric cardiology is such an exciting field, how she works with referring providers, and more.

What made you decide to focus on fetal cardiology?

I enjoy being able to use ultrasound imaging to diagnose heart disease before babies are born in order to prepare families for the experience of having a newborn with congenital heart disease (CHD). 

This partnership is unique because we are able to form a relationship before the birth of the baby and continue throughout childhood. That long-term relationship is so special, and I really enjoy being able to watch these kids grow up!

What's your favorite thing about pediatric cardiology?

The world of fetal and pediatric cardiology has evolved so much in the past 50 years. We are able to identify disease and offer therapies now that would have seemed impossible not long ago. To work in a field that is constantly changing and growing is so exciting, and I am thrilled to come to work each day.  

When should referring providers recommend a fetal echo?

There are guidelines in place that list indications for screening fetal echocardiography based on fetal exposures or maternal conditions. We are also happy to evaluate anyone when there is a question about cardiac anatomy or function based on obstetric imaging.  

What's something about your specialty you wish every referring provider knew? 

Fetal cardiology is exceptional because our team is able to diagnose CHD prior to birth and we are the same group of providers that will take care of the patient postnatally. This gives us the particular skill set needed to offer important counseling on what may be expected in the newborn period and long-term as well. 

We value the opportunity to be able to start developing a partnership with families during fetal development.  

What's your approach to working with referring providers?

Communication is key when we receive a patient referral for either a screening indication or suspected disease. We are always willing and eager to discuss our findings with referring providers and make sure to send patient records back to the primary team. 

How do you handle meeting a newly referred patient? 

I like to start by asking patients what their understanding is of why they came to UVA Health to have a fetal cardiology evaluation. This gives us a place to start from so everyone is on the same page. 

Then we review our findings and what that may mean for the delivery plan and the neonatal period. When at all possible, based on the comfort level of the family and the newborn providers, our preference is to have patients continue with their delivery plan at their local hospital.

What's one thing UVA Health Children's can offer these patients that you think makes their experience better? 

The most important thing that we offer at UVA Health is the ability to have prenatal diagnosis of CHD followed by (when necessary) a delivery in the same location as the NICU and cardiology providers. This avoids separation of mom and baby after birth and allows for quick assessment and planning of any intervention that may be required.