Fetal Echocardiogram

It has been estimated that about 50-100 babies with heart defects are born every day. Until recently, little could be done for unborn babies suffering from anatomical abnormalities. Presently, improved fetal sonographic and sampling techniques, in conjunction with a better understanding of fetal pathophysiology, make therapy for the fetus an option. The most valuable and widely applied technique for evaluation of the human fetus is ultrasonography, which can be useful from the first few weeks of gestation until the time just before birth.

Every year a greater number of pregnant woman are offered an ultrasound scan at approximately 18 weeks of pregnancy. The scan incorporates a detailed anatomical survey of the fetus, and if it includes at least a four chamber view, it is an excellent opportunity to detect most forms of congenital heart diseases. In most cases, cardiologists, obstetricians and primary care physicians are cooperatively analyze views of the heart, and try to detect malformations of the heart for proper management.

Your obstetrician may want to explore the possibility of a heart defect in more detail.Heart problems are the most common birth defect, occurring in about 1 percent of children. A fetal echocardiogram is a specialized ultrasound performed by a pediatric cardiologist that focuses on the fetus's heart. The machine looks exactly the same as a regular ultrasound machine but images only the heart. It has specialized probes and hardware that allow clear delineation of the heart. There is no risk to the fetus and you do not have to have a full bladder for the test. If a heart problem is found, the pediatric cardiologist can explain the diagnosis and what it would mean for the baby after birth.

It is important to know that the fetal circulatory pattern is different than after the baby is born. That's because the placenta, not the lungs, provide oxygen to the baby. There is an extra vessel and hole in the heart that allow blood to bypass the lungs. The fetal circulatory pattern may protect the fetus from getting sick, even if there is a heart problem. This circulatory pattern also makes it impossible for the pediatric cardiologist to rule out small holes in the heart or a blockage in the blood vessel that leads to the lower half of the body. All normal studies have this limitation.

Fetal echocardiography is usually very accurate but can be limited if the baby is not in a good position or there is low amniotic fluid. Sometimes, it is recommended to come back for a second fetal echocardiogram or an echocardiogram on the baby after birth, if a complete study can't be obtained. Your pediatric cardiologist will communicate with your obstetrician to make sure the results of your fetal echocardiogram are included in your record. Pediatric cardiologists also work closely with pediatricians and neonatologists (newborn specialists) to make sure that all the doctors that may be involved in the care of your baby before and after birth are aware of any issues related to the heart.