Dr Anita Moon-Grady is a paediatric cardiologist at the University of California, San Francisco. With training in both paediatric cardiology and neonatal/perinatal medicine, Dr Moon-Grady specialises in paediatric and foetal echocardiography (imaging the heart with ultrasound) and intraoperative assessment during congenital cardiac surgery and foetal surgery. Her research interests focus on foetal cardiovascular assessment as well as on cardiac dysfunction in patients with congenital heart disease and in foetuses undergoing surgical intervention, including in multiple gestation pregnancies complicated by twin-to-twin transfusion syndrome. Working with the International Society of Ultrasound in Obstetrics and Gynecology, she is one of the editors of the UOG Special Issue on Congenital Heart Disease, which is to be released this July. Anita also sits on the Every Little Heart Matters Oversight Group.
OGMN: What drove you to choose paediatric cardiology as a career – and paediatric and foetal echocardiography in particular?
AM-G: I look at my life and career as a series of small forays into things I really enjoyed, that all came together to the path I’m on now. In medical school my favourite topics were embryology and cardiovascular physiology and while in paediatric residency I enjoyed most critical illness and our ability, as children, to overcome it with the help of medicine. I did five years of Fellowship, two in neonatal-perinatal medicine and three in cardiology. When I started my first faculty job, all of these seemed to come together, just as ‘foetal cardiology’ was a specialty beginning to define itself. Did I choose it, or did foetal echocardiography choose me? I feel as if I had the background waiting for the specialty to mature.
OGMN: As a clinical researcher, could you tell us more about your current research looking at non-invasive imaging modalities for investigating normal and abnormal cardiac function in patients with congenital heart disease and in foetuses with congenital heart disease and cardiac compromise?
AM-G: I’m really interested in subtle alterations in function and the physiology behind not just congenital heart disease but so many other maternal-foetal conditions. I enjoy using new imaging technologies along with age-old foetal physiology principles to explain an observed difference in outcomes. We have learned so much about neonatal transition and disease progression by studying the prenatal state of and response to intervention in monochorionic twins, volume-loading lesion like teratomas, and using maternal hyperoxygenation to temporarily alter foeto-placental physiology in both normal and abnormal foetal hearts.
OGMN: How could your findings effect the patient experience with regards reproductive care and the fertility journey?
AM-G: I think the greatest impact we can currently have on the patient experience is always going to be the peace-of-mind patients have, that despite receiving a terrifying or devastating diagnosis, they are getting the very best care they can get. We won’t be able to change much for most of the anatomy, but we can improve the lives of the families by helping to alleviate stress and to plan for the best possible outcome for the baby.
OGMN: You are also studying novel ways to use machine learning to improve prenatal detection of heart disease as early as the first trimester. Could you tell us more about what you hope to learn?
AM-G: I think we all know that prenatal detection needs a lot of improvement—there are still babies with HLHS and transposition being born with missed diagnoses. We are hoping to use AI to take the next step, in addition to education, to m