A fetal echocardiogram (or “echo”) is a specialized ultrasound test, similar to a routine obstetrician (OB) ultrasound, which focuses directly on the heart of the unborn baby (also called a fetus) heart. To test the heart of your developing infant, fetal echocardiography (echo) uses sound waves.
The cardiologist will take pictures of the anatomy of the fetus, including the chambers of the heart, valves, and blood vessels. Using the Doppler "color-flow" ultrasound technique, blood flow in the heart and blood vessels is also measured.
After an abnormality is seen during routine OB monitoring, ultrasound, or another risk factor, a fetal echo is recommended. Fetal echocardiograms are considered in the following conditions:
- Heart abnormality proposed by routine OB ultrasound
- History of a close family relative with a birth defect in the heart
- Diabetes in the expecting mother-to-be
- Birth defects seen in other fetal areas
- Established or suspected fetus genetic abnormality
- During pregnancy, exposure to contaminations or certain drugs
- Certain infections during pregnancy such as rubella (German measles)
- Problems involving twin pregnancies
- Abnormal fetal heart rate observed during a regular OB visit
How is a fetal echocardiogram performed?
A fetal echocardiogram is performed by a pediatric cardiologist or a maternal-fetal specialist (also called a perinatologist) who is specially qualified. Using an abdominal or transvaginal ultrasound, the examination may be performed.
- Abdominal ultrasound - Gel is added to the abdomen in abdominal ultrasound and the ultrasound transducer glides over the abdominal gel to produce the image.
- Transvaginal ultrasound - A smaller ultrasound transducer is inserted into the vagina in a transvaginal ultrasound and lies against the back of the vagina to produce an image. A transvaginal ultrasound produces a sharper image than abdominal ultrasound and is more commonly used during early pregnancy.
The transducer probe will be pushed around during the test to take pictures of various fetal heart positions and structures. Techniques often used to obtain accurate fetal heart details include:
- 2-D (2-dimensional) echocardiography - This procedure is used to see the actual structures and motion of the heart structures. On the monitor, a 2-D echo view appears cone-shaped, and the real-time motion of the structures of the heart can be observed. This helps the doctor to see the different heart systems at work and to analyze them.
- Doppler echocardiography - This Doppler method is used to assess and analyze blood flow through the chambers and valves of the heart. An indicator of the heart's functioning is the amount of blood pumped out of each beat. Doppler may also detect irregular blood flow inside the heart, which may indicate issues such as an imbalance between the heart chambers, a problem with one or two of the four valves of the heart, or problems with one or more of the four valves of the heart or a problem with the heart's walls.
- Colour Doppler - An improved type of Doppler echocardiography is Colour Doppler. Different colors are used in the color Doppler to designate the direction of blood flow. The interpretation of the Doppler images is therefore simplified.
Purpose of fetal echocardiography
Fetal echo helps find the heart problems before birth. If a heart condition can be identified early, medication is more likely to succeed. It is because:
- Healthcare providers may, in some cases, be able to address the issue before birth.
- Healthcare facilities should brace themselves for concerns that can arise during labor and childbirth.
- It is possible to arrange an early delivery.
- Treatment may be done after the baby is born. This may be surgery or medication.
What are the risks of fetal echo?
For either the fetus or the mother, fetal echo has no risks. The lowest possible settings for ultrasound are used.