Fetal Echocardiogram

A fetal echocardiogram (echo) is an ultrasound test performed during pregnancy that uses sound waves to evaluate the anatomy and function of your unborn child’s developing heart.

What is a fetal echocardiogram?

A fetal echocardiogram uses sound waves to capture images of your baby’s heart while in utero. These images provide information on the formation of your baby’s heart and whether or not the heart is working properly. A fetal echocardiogram also enables your doctor to determine how the blood is flowing through your baby’s heart. This in-depth look allows your doctor to identify any abnormalities in your baby’s blood flow or heartbeat. A fetal echocardiogram is usually performed in the second trimester of pregnancy at approximately 18 weeks. If a transvaginal ultrasound is needed, it is usually performed at approximately 12 weeks, and an additional fetal echocardiogram will occur later to confirm any findings.

There are two ways to perform a fetal echocardiogram:

• Abdominal ultrasound: This is the most common form of ultrasound used to evaluate the baby’s heart. The ultrasound probe (transducer) is gently placed on the mother’s abdomen and images are taken.
• Transvaginal ultrasound: This is typically used early in pregnancy. A small transducer is inserted into the vagina and rests against the back of the vagina while images of the baby’s heart are taken.

Why is a fetal echocardiogram performed?

Not all pregnant mothers need a fetal echocardiogram. The standard prenatal ultrasound tests can give information about whether the fetal heart and all four chambers have developed appropriately, and most pregnant women don’t need any further testing.

A fetal echocardiogram may be necessary if:

• A chromosomal or genetic abnormality has been discovered in the fetus
• A family history of congenital heart disease exists (e.g., parents, aunts, uncles, grandparents, etc.)
• A routine prenatal ultrasound has discovered potential heart abnormalities
• A sibling was born with a congenital heart defect
• The mother has abused alcohol or drugs during pregnancy
• The mother has diabetes, phenylketonuria, or a connective tissue disease, such as lupus
• The mother has taken certain medications that may cause congenital heart defects, such as anti-seizure medications or prescription acne medications
• The mother has or had rubella during pregnancy

What can I expect during a fetal echocardiogram?

Unlike other prenatal ultrasounds, you do not need a full bladder for a fetal echocardiogram. A fetal echocardiogram is performed by a pediatric cardiologist or a maternal-fetal medicine specialist. During the exam, the transducer will be used to glide a cool gel around the abdomen to obtain images of the fetal heart’s structure.

Techniques used to obtain detailed information about the fetal heart include:

• 2-D (2-dimensional) Echocardiography: This technique is used to "see" the actual structures and motion of the heart structures. A 2-D echo view appears cone-shaped on the monitor and the real-time motion of the heart's structures can be observed. This enables your doctor to see and evaluate the various heart structures at work.
• Doppler Echocardiography: This technique is used to measure and assess the flow of blood through the heart's chambers and valves. The amount of blood pumped out with each beat is an indication of the heart's functioning. Doppler ultrasonography can also detect abnormal blood flow within the heart, which can indicate problems, such as an opening between chambers of the heart, a problem with one or more of the heart's four valves, or a problem with the heart's walls.
• Color Doppler: Color Doppler is an enhanced form of Doppler echocardiography. With color Doppler, different colors are used to designate the direction of blood flow. This simplifies the interpretation of the Doppler images for your doctor.

How soon will l receive my fetal echocardiogram results?

The availability of your results will depend on the setting of the fetal echocardiogram, gestational age of the fetus, diagnoses, and quality of the images. If the study is being performed by a pediatric cardiologist, the pediatric cardiologist will meet with you as soon as the study has been completed to provide you with a detailed explanation of the results. If your initial study is performed by a maternal-fetal medicine specialist and a heart defect is found, you will be referred to a pediatric cardiologist for a more detailed diagnosis and counseling.

If the study is normal, you may be discharged or asked to have a repeat study before and/or after birth depending on the reason the study was performed initially. When a heart defect is found, your pediatric cardiologist will explain in detail the diagnosis and implications as soon as the study has been completed. In most cases, the doctor may take additional images after the sonographer has completed the initial study. In almost all cases, you will be asked to return for follow-up fetal echocardiograms to obtain more information as you prepare for delivery. Your pediatric cardiologist will give you as much information as possible and also inform you of what unknowns remain. Your future visits may include meeting with a cardiac surgeon or interventional cardiologist to learn more about heart surgery or other procedures that may be needed after birth.

Care Team Approach

The Texas Center for Pediatric and Congenital Heart Disease, a clinical partnership between Dell Children’s Medical Center and UT Health Austin, takes a multidisciplinary approach to your child’s care. This means your child and your family will benefit from the expertise of multiple specialists across a variety of disciplines. Your care team will include pediatric cardiologists, cardiothoracic surgeons, interventional cardiologists, critical care specialists, hospitalists, anesthesiologists, perfusionists, nurses, advanced practice providers, social workers, psychologists, child life specialists, dietitians, physical and occupational therapists, pharmacists, and more, who work together to provide unparalleled care for patients every step of the way. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to identify new therapies to improve treatment outcomes. We are committed to communicating and coordinating your care with your other healthcare providers to ensure that we are providing you with comprehensive, whole-person care.

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