Fetal echocardio scan

Fetal Echocardiogram

A Fetal echocardiogram (Fetal Echo) is a highly detailed ultrasound examination of the fetal heart. Although a careful examination of the heart is performed during every routine 2nd-trimester anomaly scan, sometimes it is recommended to have a more detailed examination performed with a pediatric heart specialist. We partner with pediatric cardiologists from Alaska Children's Heart and Seattle Children's Hospital to provide this service in our office.

Whether or not to have a fetal echo is a decision between you and your provider. In general, women who have an increased risk of having a baby with a congenital heart disease or in whom a cardiac malformation is suspected by an initial ultrasound study may benefit from a fetal echo. Fetal echo can be performed throughout the second and third trimesters. The optimal time for a screening fetal echo is 22- to 26 weeks. Sometimes a repeat examination is necessary.

Common indications include the following:
  • Family history of congenital heart disease
  • Abnormal fetal heart rhythm
  • Fetal heart abnormalities suspected on a routine pregnancy scan
  • Abnormality of another major organ system
  • Insulin-dependent (type 1) diabetes mellitus
  • Exposure to certain drugs during the first trimester
  • Thickened Nuchal translucency noted in first trimester
  • Pregnancies achieved by lnvitro Fertilization
  • Abnormal genetic testing
What are the limitations?

Some heart abnormalities are not detectable prenatally even with an expert detailed examination. These tend to be minor defects, such as small holes in the heart, or mild valve abnormalities. In addition, some cardiac defects do not become evident until after birth.

The fetal echocardiogram focuses on the heart. The examination may not see defects in other parts of the fetus.

What are the Implications of an
abnormal Fetal Echo?

Detecting a heart defect increases the risk of finding other malformations in the child. A detailed ultrasound of the rest of the fetus by a maternal-fetal medicine specialist and/or amniocentesis may be necessary. A serious or even life-threatening heart abnormality may have a significant impact on the future of the child. In such an event, you will be counseled by the Pediatric Cardiologist at the time of the examination.

Currently, only cardiac rhythm disturbances are being treated before birth. In the future, a number of structural cardiac defects may be treated before birth.

In many cases of congenital heart disease diagnosed prenatally, it is safest to deliver the baby at a center where postnatal treatment is available. This is especially true if surgery is required soon after birth. Determination of whether delivery can take place in Alaska or at a specialized center in the ”Lower 48“ will be made by the Pediatric Cardiologist

Who can counsel or advise me
on cardiac findings?

A perinatologist or obstetrician can advise you about the management of your pregnancy.

A pediatric cardiologist is in the best position to advise about the outlook for your child's heart problem.

A genetic counselor can provide information about a fetus with an associated genetic syndrome, if present, and advise about future pregnancies.

A cardiac surgeon can give details about surgical procedures that may be needed.

A nurse, who is familiar with heart disease in children, can provide information about caring for a child with congenital heart disease.