Fetal Echocardiography

Health care providers recommend fetal echo in these cases:

• Another child was born with a heart defect
• Family history of genetic heart problems
• Genetic problem found in the fetus
• You are taking certain medicines that may cause congenital heart defects. These include certain medicines for seizures, depression and acne. They also include nonsteroidal anti-inflammatory medicines (NSAIDs) and blood pressure medicines (ACE-inhibitors).
• You have abused alcohol or drugs during your pregnancy
• You have certain health problems such as diabetes, lupus or phenylketonuria
• You have had certain infections during your pregnancy. These include German measles (rubella) or cytomegalovirus.
• You had abnormal test results from other tests
• You conceived by assisted reproductive technology
• Your baby was noted to have too fast, slow or irregular heart beats on exam
• Abnormalities seen on fetal ultrasound
• You became pregnant at an advanced age

If you have risk factors such as a family history of heart problems, fetal echoes are often done in the second trimester of pregnancy. This is at about 18 to 24 weeks.

Fetal echo does not have any risks for either the fetus or mother. The lowest possible ultrasound settings are used.

You don't need to do anything to get ready for fetal echo. Plan for 30 minutes to two hours for the test.

A specially trained pediatric cardiologist, maternal-prenatal medicine specialist, obstetrician or radiologist does fetal echo. In general, the steps include:

• You will lie on an exam table. You won’t likely need to change your clothes. 
• The provider will put gel on your belly. 
• The provider will use an electronic device called a transducer that sends out sound waves. 
• He or she will move the transducer around to get the best images of the prenatal heart. You may feel pressure as the transducer moves over your belly.
• Once the exam is complete, the gel is wiped off. 

Sometimes an endo-vaginal echocardiogram is done early in pregnancy to monitor the developing fetus' heartbeat. Your health care provider puts a small echocardiogram probe into the vagina instead of putting it on the belly.

Your health care provider will look at the results. He or she may order more tests or procedures. They may include:

• Treatment. This may be medicine or procedures to treat prenatal heart problems.
• Prenatal wellness assessments. To check overall prenatal health, you may be asked to count prenatal movements.
• Nonstress test. This checks prenatal heart rate and movement.
• Biophysical profile (BPP). This is an ultrasound exam to check overall prenatal health. It checks heart rate, breathing, movement, muscle tone and the amount of amniotic fluid.
• Ultrasounds or echocardiography. These are tests done to confirm the diagnosis. They also follow prenatal growth, watch for prenatal heart changes and check for other problems.
• Amniocentesis. This test can find chromosomal and genetic disorders and certain birth defects. The healthcare provider puts a needle through the abdominal and uterine wall and into the amniotic sac. He or she takes a sample of amniotic fluid.
• Genetic counseling. A counselor helps you learn your risks of having a baby with genetic defects.