You have just received the results of the routine 18 week prenatal ultrasound scan of your baby. It is possible that your baby has a congenital heart malformation. The heart defect appears to be a Tetralogy of Fallot, which can usually be successfully operated on (open heart surgery - ~95% success rate) either immediately at birth or at a later date. The child will suffer from blue spells and be tired and breathless, but after successful surgery could expect to lead a relatively normal life. However, sometimes this heart defect is associated with other syndromes include mental retardation of mild to severe form. These other syndromes are the result of chromosomal abnormalities (e.g. Trisomy 21 (Down Syndrome) - varying degrees of severity, Trisomy 18 or Trisomy 13 - both with severe defects resulting in death within weeks ... however recent advances in heart surgery can allow these children to live longer). These can be tested for by using amniocentesis, which carries with it a 1% risk of producing a spontaneous miscarriage and takes three weeks for results, or by fetal blood sampling, which has a 5% risk of producing a miscarriage but has results in 24 hours. You are at week 19 in your pregnancy, and abortions will only be performed until week 20, or week 24 under special circumstances by some doctors.
What path should be taken?
What issues are raised?
What is the role of amniocentesis / fetal blood tests if abortion is not contemplated?