What Is a Fetal Echocardiography?

    Fetal echocardiography is a test used to view your unborn baby’s heart, similar to an ultrasound. Your doctor will order this test if he or she needs a better view of your baby’s heart before delivery.

    This exam allows your doctor to view the structure and function of the fetus’s heart. It is typically done in the second trimester, when a woman is 18 to 24 weeks into her pregnancy. Fetal echocardiography is much like an ultrasound. It uses sound waves that “echo” off the structures of the heart. A machine analyzes these sound waves and creates a picture (echocardiogram) of the heart’s interior, which provides information on how your baby’s heart has formed and whether it is working properly. It also allows your doctor to see the blood flow through the heart and detect any defects or abnormalities in the blood flow or heartbeat.

    When Is Fetal Echocardiography Used?

    Not all pregnant women need an echocardiogram. For most women, a basic ultrasound will show that all four chambers of the baby’s heart have developed. However, your obstetrician may recommend you have this procedure if previous ultrasounds or tests detected an abnormal heartbeat or other potential heart problems in the unborn baby.

    You might also have this test if:

    • your baby is at risk for a heart abnormality or congenital (present at birth) disorder
    • you have a family history of heart disease
    • you already have a child with a heart condition
    • you have used drugs or alcohol during your pregnancy
    • you have taken certain medications or been exposed to medications that can cause heart defects, such as those for epilepsy or prescription acne drugs
    • you have other medical conditions, including rubella, type 1 diabetes, lupus, or phenylketonuria—an inability to break down an important amino acid called phenylalanine

    Some obstetricians can perform this test themselves. However, it is usually done by an experienced ultrasound technician, called an ultrasonographer. Following the exam, the echocardiogram should be reviewed by a cardiologist, particularly one who specializes in pediatric medicine.

    Do I Need to Prepare for the Procedure?

    You do not need to do anything to prepare for this test. Unlike other prenatal ultrasounds, you will not need to have a full bladder for the exam.

    The test can take anywhere from 30 minutes to two hours, so it may be a good idea to bring another adult to your appointment if you have small children with you.

    What Happens During the Examination?

    This test is similar to a routine pregnancy ultrasound, and may be performed through your abdomen (abdominal echocardiography) or through your vagina (transvaginal echocardiography).

    An abdominal echocardiography is very much like an ultrasound. You will be asked to lie down and expose your belly. An ultrasound technician will apply a special lubricating jelly to your skin. This prevents friction so he or she can rub the ultrasound transducer (a device that sends and receives sound waves) on your skin. The jelly also helps transmit the sound waves.

    The transducer sends high-frequency sound waves through your body. The waves echo as they hit a dense object, such as your baby’s heart. Those echoes are then reflected back into a computer. The sound waves are at too high of a pitch for the human ear to hear.

    After the procedure, the gel will be cleaned off your abdomen. You will be free to go about your day and normal activities.

    For a transvaginal echocardiography, you will need to undress from the waist down and lie on the exam table. A technician will insert a small probe into your vagina. From there, the probe will use sound waves to create an image of your baby’s heart.

    A transvaginal echocardiography is typically used in earlier stages of pregnancy, and may provide a clearer image of the fetal heart.

    Are There Any Risks to This Exam?

    Since the echocardiogram uses ultrasound technology and no radiation, there are no risks associated with it.

    What Do the Results Mean?

    Normal results mean that no cardiac abnormality was found. It is important to remember that echocardiography cannot always be used to diagnose every condition. Some problems—such as a hole in the heart—are difficult to see even with advanced equipment. You may need to have this test repeated more than once, and you may need to go for additional testing if the doctor suspects something else is wrong.

    If the cardiologist finds an issue, such as a heart defect, rhythm abnormality, or other problem, you may need to have more tests, such as a fetal MRI or other high-level ultrasounds. During your follow-up appointment, the cardiologist should explain the results to you, answer any questions you might have, and refer you to the appropriate resources and specialists to treat your child’s condition.

    Why Is This Test Important?

    Abnormal results from a fetal echocardiography can be scary, especially when they are inconclusive or require that you get more testing to figure out what might be wrong.

    However, once you know what is wrong, you can better manage your pregnancy and be prepared for when the baby is born. In some cases, information from this test can help you and your doctor plan any treatments that may need to happen after delivery, such as correctional surgery. You can also get the support and counseling you need to make good decisions for the remainder of your pregnancy.