The Fetal Echocardiogram: What is it and who needs it?

A fetal echocardiogram is a detailed ultrasound of the baby’s heart performed before the baby is born.  It is a more comprehensive evaluation of the heart than what is done during the typical obstetrical ultrasound.  A fetal echocardiogram can evaluate both the structure and function of the heart.  For this reason it is useful in looking for birth defects of the heart and heart rhythm problems as well as for assessing fetal well being if the baby is found to have other potential problems during the pregnancy.

There are three categories of risk factors that should prompt fetal cardiac evaluation with a fetal echocardiogram: maternal risk factors, fetal risk factors, and family risk factors.  Maternal risk factors include a mother who has taken medications that are known to cause congenital heart defects, a mother who has specific health problems (such as diabetes or an autoimmune disease), or a mother who has had certain infections during the pregnancy (such as rubella or CMV).  Fetal risk factors include a fetus that has been diagnosed with a genetic abnormality (such as Down syndrome) or has had an abnormal amniocentesis, a fetus who has abnormalities in other organs (such as the brain, kidney, or GI tract), a fetus with an abnormal heart rate or rhythm (too fast or too slow), or a fetus in whom a heart abnormality is suspected on a routine ultrasound.  Familial risk factors include a first degree relative (father, mother, or sibling) with a congenital heart defect or a known family history of disorders that are passed from generation to generation (such as Marfan syndrome, DiGeorge syndrome, or tuberous sclerosis).

A fetal echocardiogram is generally performed by a songographer in conjunction with a pediatric cardiologist specialized in fetal congenital heart disease.  A fetal echocardiogram can be performed any time after 17-18 weeks gestation, though the images are usually optimal in the 20-24 week range (a transvaginal fetal echocardiogram can be performed as early as 12-13 weeks, but this approach is not commonly used).  A typical exam takes from 30-90 minutes. 

Following the fetal echocardiogram, the cardiologist will sit with you and explain in detail (with pictures and diagrams) the findings of the test and what it means for you and your baby.  If a congenital heart defect is identified, we will do our best to make sure you understand every aspect of the diagnosis and how it will affect the baby before delivery, during delivery, and throughout your child’s lifetime.

Dr. Tracy Laird

Posted by Dr. Penn Laird Jr. .