Heartening Web site helps infants

University researchers have developed software and set up a World Wide Web site to help doctors detect heart abnormalities in developing fetuses, potentially saving hundreds of infant lives each year. More than 30,000 infants are born with heart defects in the United States each year -- defects which can prove fatal if not detected by doctors. The problem stems from the fact that obstetricians -- the doctors responsible for monitoring fetal development for such abnormalities -- are not trained to look for heart defects. "There are some [defects] that are uncommon that an obstetrician wouldn't see everyday," explained Michael Parsons, an obstetrics expert at the University of South Florida. Most obstetricians check only the fetus' size, sex and number of limbs, he said. And Penn Biophysics Professor Krzysztof Wroblewski -- who co-authored the software and Web site -- stressed that "we can't ask [obstetricians] to be cardiologists, too." The new software, which is still being tested by doctors across the country, provides obstetricians with images and instructions on how to look for heart problems in fetal sonograms, images captured from a mother's womb. "It's sort of a library for physicians who have problems and a need for fast and reliable reference," Wroblewski said. Currently, most doctors use piles of expensive cardiology textbooks as references when looking for the defects. But the books lack the high quality images present in the new software, known as the Fetal Echo Expert System, or FetEx. Wroblewski said he hopes the software will help doctors detect abnormality, but stressed that physicians would still be ultimately responsible for giving a more detailed diagnosis. "The most important thing is to tell the obstetrician, 'Hey, something is wrong! Send this patient to a cardiologist'," he said If cardiologists knew about infants' heart defects before birth, they could recommend that the children be delivered at hospitals best equipped to handle heart abnormalities, maximizing the infants' chance of survival. "[FetEx] could also be a good teaching tool," said Parsons, noting that medical students could compare pictures of normal hearts to pictures of defective ones. Wroblewski stressed that FetEx must go through extensive testing before finding its way into obstetricians' offices. "It's not a word processor," he said. "Somebody's life may be depending on this." Though not as extensive as FetEx, the "Fetal Echocardiography Homepage" informs obstetricians around the world about fetal heart defects. The free service has been accessed in almost every continent. "We haven't gotten Antarctica -- yet," said Wroblewski, who will present the site at an Internet conference in Toronto next month. The new site was Wroblewski's first experience with Web publishing. "I did the HTML stuff myself," he said, explaining that he learned the programming language out of a textbook. FetEx and the Web site represent a joint effort from biophysicists, cardiologists, and medical informatics specialists across the University. Cardiology Professors Zhi Yun Tian and Jack Rychik selected the images to be posted on the Web site, while Wroblewski's son Piotr, an Engineering junior, edited the images and contributed to FetEx's development. The Web site can be reached at http://www.med.upenn.edu/fetus/ echo.htm.