“Esophageal Atresia is a congenital disorder in which a baby’s esophagus does not form properly during pregnancy. Symptoms include include white, frothy bubbles in the mouth, vomiting, and coughing/choking when feeding. Treatment includes surgery”.
Yale Medicine (https://www.yalemedicine.org/conditions/tracheoesophageal-fistula-and-esophageal-atresia)
Esophageal atresia is a birth defect in which part of a baby’s esophagus (the tube that connects the mouth to the stomach) does not develop properly.
Esophageal atresia is a birth defect of the swallowing tube (esophagus) that connects the mouth to the stomach. In a baby with esophageal atresia, the esophagus has two separate sections—the upper and lower esophagus—that do not connect. A baby with this birth defect is unable to pass food from the mouth to the stomach, and sometimes difficulty breathing.
Esophageal atresia often occurs with tracheoesophageal fistula, a birth defect in which part of the esophagus is connected to the trachea, or windpipe.
There are four types of esophageal atresia: Type A, Type B, Type C and Type D.
Researchers estimate that about 1 in every 4,100 babies is born with esophageal atresia in the United States.1 This birth defect can occur alone, but often occurs with other birth defects.
Like many families of children with a birth defect, CDC wants to find out what causes them. Understanding the factors that can increase the chance of having a baby with a birth defect will help us learn more about the causes. CDC funds the Centers for Birth Defects Research and Prevention, which collaborate on large studies such as the National Birth Defects Prevention Study (NBDPS; births 1997-2011) and the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS; began with births in 2014), to understand the causes of and risks for birth defects, including esophageal atresia.
The causes of esophageal atresia in most babies are unknown. Researchers believe that some instances of esophageal atresia may be caused by abnormalities in the baby’s genes. Nearly half of all babies born with esophageal atresia have one or more additional birth defects, such as other problems with the digestive system (intestines and anus), heart, kidneys, or the ribs or spinal column.
Recently, CDC reported on important findings about some factors that increase the risk of having a baby with esophageal atresia:
CDC continues to study birth defects, such as esophageal atresia, and how to prevent them. If you are pregnant or thinking about becoming pregnant, talk with your doctor about ways to increase your chances of having a healthy baby.
Esophageal atresia is rarely diagnosed during pregnancy. Esophageal atresia is most commonly detected after birth when the baby first tries to feed and has choking or vomiting, or when a tube inserted in the baby’s nose or mouth cannot pass down into the stomach. An x-ray can confirm that the tube stops in the upper esophagus.
Once a diagnosis has been made, surgery is needed to reconnect the two ends of the esophagus so that the baby can breathe and feed properly. Multiple surgeries and other procedures or medications may be needed, particularly if the baby’s repaired esophagus becomes too narrow for food to pass through it; if the muscles of the esophagus don’t work well enough to move food into the stomach; or if digested food in the stomach consistently moves back up into the esophagus.
“Radon is a naturally occurring radioactive gas emitted from the ground. Radon is odorless, tasteless and colorless, and can enter a home through cracks in floors, basement walls, foundations and other openings. Radon can be present at high levels inside homes, schools and other buildings. Radon in homes is more common than you think. Pennsylvania has one of the nation’s most serious radon problems. High levels of radioactive radon gas have been found in every county but most places in the Commonwealth remain undertested, so this isn’t something that should be taken lightly.”
American Lung Association (https://www.lung.org/media/press-releases/pa-radon-2024)
EPA and the U.S. Surgeon General recommend that all homes in the U.S. be tested for radon. Testing is easy and inexpensive.
Learn more about testing your home, including how to obtain an easy-to-use test kit.
Look for radon events in your community.
3-Spread the word –
Spend time during National Radon Action Month encouraging others to learn about radon and test their homes.
Tell your family and friends about the health risk of radon. Encourage them to test their homes.
Plan an activity in your community to help raise awareness.
Write an op-ed or letter to the editor using samples from the event planning resources.
Attract media attention by working with a local official to get a radon proclamation.
View or order EPA’s free radon publications.
4-Buy a radon-resistant home –
– If you are considering buying a new home, look for builders who use radon-resistant new construction. Read more about radon-resistant new construction, “Building Radon Out: A Step-by-Step Guide to Build Radon-Resistant Homes“.
Build Green: It’s Easy to Build New Homes Radon-Resistant …”The good news is you can build your customers a safer, healthier, radon-resistant home. The techniques to prevent radon from entering a home are practical and straightforward for any builder. It’s an inexpensive way to offer families a benefit that could reduce their risk of lung cancer. And it’s a smart way to build trust between you and your customer.” Fuad Reveiz, Member of the National Association of Home Builders.
Promote radon risk reduction during National Radon Action Month and throughout the year.
Set a bold goal for your community to reduce radon risk. Whether you are conducting a single National Radon Action Month event, or developing an entire radon risk reduction program for your community, it is important to set goals to define what you will achieve.
Collaborate with local radon partners. Coordinate with your state radon program and local radon professionals to hold events and measure results.
Plan a National Radon Action Month activity or event to kick off your campaign. Conduct activities and events designed to raise awareness, recognize successful efforts and share best practices. Set goals and establish ways to measure results from your activities and events.
An excellent way to get your entire community involved is the National Radon Poster Contest. Students ages 9-14 are encouraged to create posters that raise radon awareness. Entries will be accepted from March through October from students in all U.S. states, tribal nations and U.S. territories.
Visit to Kansas State University National Radon Services for more information about this year’s contest and how you can get involved.
Promote your activity or event on EPA’s Web site and elsewhere. Use tools such as blogs and the Share Your Story feature on Radonleaders.org to promote your activities and share outreach ideas with the broader radon community.
Work with the media to spread your message. Work with your local media outlets to run Public Service Announcements (PSAs) and generate media coverage of radon topics, events and activities in your community.
“You can’t see, smell or taste radon, but it could be present at a dangerous level in your home. Radon is the leading cause of lung cancer deaths among nonsmokers in America and claims the lives of about 21,000 Americans each year. In fact, the EPA and the U.S. Surgeon General urge all Americans to protect their health by testing their homes, schools and other buildings for radon.
Exposure to radon is a preventable health risk and testing radon levels in your home can help prevent unnecessary exposure. If a high radon level is detected in your home, you can take steps to fix the problem to protect yourself and your family.”
United States Environmental Protection – EPA
(https://www.epa.gov/radon/national-radon-action-month-information)
Radon is a naturally occurring gas that seeps out of rocks and soil. Radon comes from uranium that has been in the ground since the time the earth was formed, and the rate of radon seepage is very variable, partly because the amounts of uranium in the soil vary considerably. Radon flows from the soil into outdoor air and also into the air in homes from the movement of gases in the soil beneath homes. Outside air typically contains very low levels of radon, but it builds up to higher concentrations indoors when it is unable to disperse. Some underground mines, especially uranium mines, contain much higher levels of radon.
Radon is present outdoors and indoors. It is normally found at very low levels in outdoor air and in drinking water from rivers and lakes. It can be found at higher levels in the air in houses and other buildings, as well as in water from underground sources, such as well water.
Radon breaks down into solid radioactive elements called radon progeny (such as polonium-218, polonium-214, and lead-214). Radon progeny can attach to dust and other particles and can be breathed into the lungs. As radon and radon progeny in the air break down, they give off radiation that can damage the DNA inside the body’s cells.
1-At home and in other buildings.
For both adults and children, most exposure to radon comes from being indoors in homes, offices, schools, and other buildings. The levels of radon in homes and other buildings depend on the characteristics of the rock and soil in the area. As a result, radon levels vary greatly in different parts of the United States, sometimes even within neighborhoods. Elevated radon levels have been found in every state.
Radon gas given off by soil or rock can enter buildings through cracks in floors or walls; construction joints; or gaps in foundations around pipes, wires, or pumps. Radon levels are usually highest in the basement or crawl space. This level is closest to the soil or rock that is the source of the radon. Therefore, people who spend much of their time in basement rooms at home or at work have a greater risk for being exposed.
Small amounts of radon can also be released from the water supply into the air. As the radon moves from the water to air, it can be inhaled. Water that comes from deep, underground wells in rock may have higher levels of radon, whereas surface water (from lakes or rivers) usually has very low radon levels. For the most part, water does not contribute much to overall exposure to radon.
Radon exposure can also occur from some building materials if they are made from radon-containing substances. Almost any building material made from natural substances, including concrete and wallboard, may give off some level of radon. In most cases these levels are very low, but in a few instances these materials may contribute significantly to radon exposure.
Some granite countertops may expose people to different levels of radon. Most health and radiation experts agree that while a small portion of granite countertops might give off increased levels of radon, most countertops give off extremely low levels.
According to the US Environmental Protection Agency (EPA), it’s very unlikely that a granite countertop in a home would increase the radiation level above the normal, natural background level that comes from nearby soil and rocks. Still, people concerned about radon from countertops and from other household sources can test these levels using home detection kits or can hire a professional to do the testing (see the section “How can I avoid exposure to radon?”).
According to the EPA, the average indoor radon level is about 1.3 picocuries per liter (pCi/L). People should take action to lower radon levels in the home if the level is 4.0 pCi/L or higher. The EPA estimates that nearly 1 out of every 15 homes in the United States has elevated radon levels.
Outdoors, radon generally disperses and does not reach high levels. Average levels of radon outdoors, according to the EPA, are about 0.4 pCi/L.
2-At certain jobs
In the workplace, people working underground, such as some types of miners, are among the most likely to be exposed to high levels of radon. High death rates from lung problems among miners in some parts of the world were first noted hundreds of years ago, long before people knew what radon was. Studies of radon-exposed miners during the 1950s and 1960s confirmed the link between radon exposure and lung cancer.
Higher levels of radon exposure are also more likely for people who work in uranium processing factories or who come in contact with phosphate fertilizers, which may have high levels of radium (an element that can break down into radon).
Does radon cause cancer?
Being exposed to radon for a long period of time can lead to lung cancer. Radon gas in the air breaks down into tiny radioactive elements (radon progeny) that can lodge in the lining of the lungs, where they can give off radiation. This radiation can damage lung cells and eventually lead to lung cancer.
Cigarette smoking is by far the most common cause of lung cancer in the United States, but radon is the second leading cause. Scientists estimate that about 20,000 lung cancer deaths per year are related to radon.
Exposure to the combination of radon gas and cigarette smoke creates a greater risk for lung cancer than either factor alone. Most radon-related lung cancers develop in smokers. However, radon is also thought to cause a significant number of lung cancer deaths among non-smokers in the United States each year.
Although radon is chemically inert and electrically uncharged, it is radioactive, which means that radon atoms in the air can spontaneously decay, or change to other atoms. When the resulting atoms, called radon progeny, are formed, they are electrically charged and can attach themselves to tiny dust particles in indoor air. These dust particles can easily be inhaled into the lung and can adhere to the lining of the lung. The deposited atoms decay, or change, by emitting a type of radiation called alpha radiation, which has the potential to damage cells in the lung. Alpha radiations can disrupt DNA of these lung cells. This DNA damage has the potential to be one step in a chain of events that can lead to cancer. Alpha radiations travel only extremely short distances in the body. Thus, alpha radiations from decay of radon progeny in the lungs cannot reach cells in any other organs, so it is likely that lung cancer is the only potentially important cancer hazard posed by radon.
For centuries, it has been known that some underground miners suffered from higher rates of lung cancer than the general population. In recent decades, a growing body of evidence has causally linked their lung cancers to exposure to high levels of radon and also to cigarette smoking. The connection between radon and lung cancer in miners has raised concern that radon in homes might be causing lung cancer in the general population, although the radon levels in most homes are much lower than in most mines. The National Research Council study, which has been carried out by the sixth Committee on Biological Effects of Ionizing Radiation (BEIR) VI, has used the most recent information available to estimate the risks posed by exposure to radon in homes.
You can’t see, smell or taste radon, but it could be present at a dangerous level in your home. Radon is the leading cause of lung cancer deaths among nonsmokers in America and claims the lives of about 21,000 Americans each year. In fact, the EPA and the U.S. Surgeon General urge all Americans to protect their health by testing their homes, schools and other buildings for radon.
Exposure to radon is a preventable health risk and testing radon levels in your home can help prevent unnecessary exposure. If a high radon level is detected in your home, you can take steps to fix the problem to protect yourself and your family.
Radon, being naturally occurring, cannot be entirely eliminated from our homes. Of the deaths that attributes to radon (both independently and through joint action with smoking), perhaps one-third could be avoided by reducing radon in homes where it is above the “action guideline level” of 148 Bqm-3 (4 pCiL-1) to below the action levels recommended by the Environmental Protection Agency.4
The risk of lung cancer caused by smoking is much higher than the risk of lung cancer caused by indoor radon. Most of the radon-related deaths among smokers would not have occurred if the victims had not smoked. Furthermore, there is evidence for a synergistic interaction between smoking and radon.
“A few precautions that are recommended for all pregnant women include the following:
American College of Obstetricians and Gynecologists ACOG
(https://www.acog.org/womens-health/faqs/reducing-risks-of-birth-defects)
Though not all birth defects can be avoided, prenatal care and awareness of past or current conditions can help with prevention.
It’s not always possible to detect all birth defects in utero. However, high-resolution ultrasounds done by certified prenatal ultrasound groups make it possible to diagnose defects that will cause a significant impact before birth.
Baschat says: “At the Center for Fetal Therapy, we recommend that pregnant women have the first-trimester nuchal translucency scan between 11 and 14 weeks and the anatomy scan between 18 and 20 weeks. These two ultrasounds provide us with the best opportunity for detecting birth defects.”
In recent years, some pregnant women have turned down the first-trimester ultrasound because a maternal screening blood test now exists for Down syndrome. The ultrasound is still strongly recommended, though, because there are many other serious birth defects that can be detected this early in pregnancy.
Absolutely. While there are many different types of birth defects, it’s extremely important to try to correct those that damage vital organs before the baby is born. The Center for Fetal Therapy specializes in treating several of these defects in utero, including:
Fetal treatments also exist for conditions that make the baby unhealthy, even if they are not considered to be birth defects. For example, if a fetus has an irregular heartbeat, you can give the mother medication that will cross the placenta and treat the fetus.
By treating fetal conditions in utero rather than waiting until after birth, fetuses are given significantly better chances of survival and a reduced need for major surgery after birth. For example, with a condition like twin-to-twin transfusion syndrome, in which identical twins develop a blood volume imbalance, both babies could die without any intervention. By performing laser surgery in utero, there is approximately a 95 percent chance that at least one baby will survive.
Explains Baschat, “Success rates vary depending on the condition, available treatments and the individual patient, but overall, where fetal interventions are available, we see a much higher rate of survival for affected fetuses.”
This will depend on the individual condition and type of surgery performed. For all fetal surgeries, your baby needs to be delivered at a hospital where pediatric subspecialties are in-house so the baby’s care can be managed after birth. Baschat says: “Many of the treatments we perform require patients to deliver at the highest-level multispecialty hospital, like The Johns Hopkins Hospital. This way, all prenatal and postnatal care is available to you in one location.”
All future children will not definitively be affected by the same birth defect, but it will depend on what the cause was. If the birth defect was caused by a genetic mutation, there may be a higher likelihood of recurrence, but if you seek care from a specialized center, maternal-fetal medicine specialists and genetic counselors can work with you to assess future risk.
The risk of some conditions can be determined before you become pregnant through genetic testing. If that doesn’t exist for the condition in question, maternal-fetal medicine specialists and genetic counselors can genetically test your fetus during pregnancy to see if she or he exhibits the mutation that affected your previous child.
There are many forums online, whether on the web or social media platforms, in which parents come together. “At our center, we reach out to previous patients to see if they are interested in communicating with new patients affected by the same condition,” Baschat explains. “They can empathize about the specific birth defect, but they can also provide guidance and advice about the experience of working with our center throughout the pregnancy and after the baby is born.”
Through prenatal diagnosis and understanding fetal disease better, physicians are learning more about what harms the fetus and what may be of benefit before birth. Additionally, new uses for minimally invasive surgical equipment are regularly being discovered.
There are also stem cell therapies, genomic medicine and a whole host of related treatments that are currently used for children and adults. One day, these may also apply to the fetus. “While it’s hard to predict the future, we’re currently doing things we couldn’t have foreseen 10 years ago, so we’re very hopeful for continued advancements in fetal care,” says Baschat.
“The reported incidence of PDA in term neonates is only 1 in 2,000 births, accounting for 5%–10% of all congenital heart disease.6 The incidence of PDA in preterm neonates is far greater, with reports ranging from 20%–60% (depending on population and diagnostic criteria).3 The increased incidence of PDA in the preterm infant is attributable to the lack of normal closure mechanisms due to immaturity. Gestational age and weight are intimately linked to PDA in preterm neonates. Specifically, PDA is present in 80% of infants weighing less than 1,200 g at birth, compared to 40% of infants weighing less than 2,000 g at birth.1,7 Furthermore, symptomatic PDA is present in 48% of infants with a birth weight of less than 1,000 g.”
National Library of Medicine (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462096/)
The duct should close in the first hours after birth. If it does not, the blood begins to shunt from the aorta into the pulmonary artery and hyperperfuse the lungs. The left side of the heart will have an increase in blood return and become volume overloaded. Too much blood is going to the lungs. RA – RV – Lungs _ LA – LV – Aorta now blood shunts backwards because pressure in L side higher than R so pressure in aorta in higher it backflows (it is already oxygenated) and prevents the blood that needs to be oxyenate doesn’t get there. Dispalces blood that needs to be oxygenated. Mixed blood in oxygenation. L sided heart failure. L to R shunt. THIS IS CALLED A LEFT-TO-RIGHT SHUNT.
Simply put, this is a hole in your baby’s aorta that doesn’t close.
Aorta is the largest artery in the body, the aorta arises from the left ventricle of the heart, goes up (ascends) a little ways, bends over (arches), then goes down (descends) through the chest and through the abdomen to where ends by dividing into two arteries called the common iliac arteries that go to the legs which is called the femoral artery than.
Anatomically, the aorta is traditionally divided into the ascending aorta, the aortic arch, and the descending aorta. The descending aorta is, in turn, subdivided into the thoracic aorta (that descends within the chest) and the abdominal aorta (that descends within the belly).
The aorta gives off branches that go to the head and neck, the arms, the major organs in the chest and abdomen, and the legs. It serves to supply them all with oxygenated blood. The aorta is the central conduit from the heart to the body. A hole in the aorta causes many problems.
During pregnancy, the hole allows your baby’s blood to bypass his lungs and get oxygen from your umbilical cord. After he’s born, he starts to get oxygen from his own lungs, and the hole has to close.
If it doesn’t, it’s called patent ductus arteriosus, or PDA. Small PDAs may get better on their own. A larger one could need surgery.
I-transposition of the great arteries. This means that the right and left chambers of your baby’s heart are reversed. His blood still flows normally, but over time, his right ventricle doesn’t work as well because it must pump harder.
D-transposition of the great arteries. In this condition, the two main arteries of your baby’s heart are reversed. His blood doesn’t move through the lungs to get oxygen, and oxygen-rich blood doesn’t flow throughout his body. He will have to have surgery to repair this condition, usually within the first month of his life.
Single ventricle defects. Babies are sometimes born with a small lower chamber of the heart, or with one valve missing. Different types of single ventricle defects include:
In some cases, your doctor can spot congenital heart problems when your baby is still in the womb. But he can’t always diagnose the defect until after birth and until your baby shows signs of a problem.
Many mild congenital heart defects are diagnosed in childhood or even later because they don’t cause any obvious symptoms. Some people don’t find out they have them until they’re adults.
Whatever the type of congenital heart defect, rest assured that with advances in diagnostic tools and treatments, there’s a much greater chance of a long, normal life than ever before.
Heart transplants are recommended for children who have serious heart problems. These children are not able to live without having their heart replaced. Illnesses that affect the heart in this way include complex congenital heart disease, present at birth at times. They also include heart muscle disease (cardiomyopathy).
