Fetal Echocardiogram and Fetal Heart Disease

The fetal echocardiogram, or fetal echo, is a well established, in-depth ultrasound test done during pregnancy by a specially trained pediatric cardiologist or maternal-fetal medicine doctor, which is used to diagnose congenital heart disease and other defects in the fetus. Very few medical facilities are accredited to perform this test. In 2002, Woman’s Hospital and Pediatric Cardiology Associates partnered to become the first group in Louisiana and one of the first in the nation to be granted this distinction.

If your doctor determines that your baby is at risk for defects detected by a fetal echo, this test may be recommended to you. The best time to do a fetal echo is between the 20th and 24th weeks of pregnancy. By this time, the heart is large enough for most defects to be seen. If a doctor believes a fetal echo is necessary, most health insurance companies will cover the test; check with your insurance agent before you have the test done.

Reasons to have a fetal echo

• Family history of congenital (present at birth) heart disease
• An ultrasound that shows something abnormal
• You’re pregnant and have diabetes
• Chromosomal problems have been detected in other tests
• The fetus has another defect or hydrops (fluid build-up in an organ)
• You’re pregnant and have been exposed to a drug that may cause heart defects
• If defects are found, the fetus may benefit from early preparation or treatment, sometimes even before birth
• Research shows the fetal echo to be 85-90% accurate
• Early awareness of defects gives you a chance to have genetic counseling and gives doctors time to prepare for treatment options

Some (but not all) problems are detected by fetal echo, including:

• Venticular septal defect - A small or large hole in the tissue that separates the two lower chambers of the heart
• Pulmonary stenosis – problems with the blood vessel leading to the lung
• Atrioventricular canal defect and hypoplastic left heart syndrome – malformations associated with Down syndrome

Procedure

This test is similar to other ultrasounds done during pregnancy, but with in-depth focus on the heart area of the fetus. You will lie flat on an examining bed or table while the test is performed, which usually takes from 15 to 45 minutes. Afterward, your doctor discusses findings with you and determines whether further tests, such as bloodwork or an amniocentesis, are required.