September 2023
What do you do, David?
I'm a consultant in paediatric and fetal cardiology at Evelina London Children’s Hospital. I started my training in paediatrics in 2007 and have been working in paediatric cardiology since 2012, caring for and treating children with heart problems. This includes problems present from birth, known as congenital heart disease (CHD).
I now specialise in fetal cardiology, diagnosing and managing heart problems before birth. This can be technically very challenging, for obvious reasons. So my colleagues and I need to work with cutting-edge technology, such as MRI, to help diagnose heart problems while the baby is in the womb.
When are people referred to fetal cardiology?
Our patients are referred to us in fetal cardiology for various reasons. For example, if an ultrasound scan in pregnancy has shown a potential problem with the baby’s heart, or if there is a history of CHD in their family.
Guy’s and St Thomas’ NHS Foundation Trust is a very large trust covering sites across London and the south east of England. Across Evelina London Children’s Hospital and Royal Brompton Hospital we evaluate over 4,500 high-risk pregnancies a year, with fetal CHD detected in around 1 in 3 of those patients. Accurately diagnosing CHD before birth means we can fully inform our patients about the diagnosis in their baby, as well as plan to provide the necessary treatment for them as soon as they're born. We know that getting the diagnosis right before birth improves both survival and long-term health of children with CHD.
What are you most proud of?
I'm most proud of the part I played in introducing MRI scanning to our fetal cardiology service at Evelina London Children’s Hospital. This was based on the work I did during my PhD at King’s College London. My research showed that we could use MRI safely and reliably to get 3D images of the heart before birth, and that this could be a really helpful addition to ultrasound for many of our patients. Once we published our results, we were able to start offering a clinical fetal cardiac MRI service for our patients as part of their routine care. We were the first and only unit in the UK to offer this. We have now performed MRI scans in nearly 700 women carrying a baby with CHD as part of their prenatal care.
Why is ongoing research important?
Our research has helped to improve our understanding of the unborn baby’s heart when there is CHD, meaning we can give the right care at the right time for newborn babies and their families. I now want to use these advanced methods to build a better picture of how the placenta, heart and brain develop together in pregnancy. This could help explain why some babies develop more severe forms of CHD than others, as well as how their time in the womb impacts their health and development over the course of their lives. This ongoing research is supported by a fellowship from the British Heart Foundation (BHF).
Who do you work with?
I'm lucky to work with an incredible team of professionals, from my colleagues in paediatric and fetal cardiology to our clinical nurse specialists, research midwives, sonographers, physicists, computer scientists, software engineers and academics. Most importantly of course I also work with the amazing patients and volunteers who so generously give their time and energy to the research. They're the ones who really make it all possible!
Our MRI service is based in the Centre of the Developing Brain in the Department of Perinatal Imaging and Health at King’s College London.
Find out more about Evelina London’s fetal cardiology service.
Watch a film about David’s research on the British Heart Foundation website.
Thank you to the children and young people who have so brilliantly illustrated our blog pages.