Fetal echocardiography is a test similar to an ultrasound. This exam allows your doctor to better see the structure and function of your unborn child’s heart. It’s typically done in the second trimester, between weeks 18 to 24.
The exam uses sound waves that “echo” off of the structures of the fetus’ heart. A machine analyzes these sound waves and creates a picture, or echocardiogram, of their heart’s interior. This image provides information on how your baby’s heart has formed and whether it’s working properly.
It also allows your doctor to see the blood flow through their heart. This in-depth look allows your doctor to find any defects or abnormalities in the baby’s blood flow or heartbeat.
Not all pregnant women need a fetal echocardiogram. For most women, a basic ultrasound will show that all four chambers of their baby’s heart have developed. Your obstetrician may recommend that you have this procedure done if previous tests detected an abnormal heartbeat in the fetus.
You may also need this test if:
- your unborn child is at risk for a heart abnormality or other disorder present at birth
- you have a family history of heart disease
- you already have a child with a heart condition
- you’ve used drugs or alcohol during your pregnancy
- you’ve taken certain medications or been exposed to medications that can cause heart defects, such as medications used to treat epilepsy or prescription acne drugs
- you have other medical conditions, including rubella, type 1 diabetes, lupus, or phenylketonuria, which is an inability to break down an important amino acid called phenylalanine
Some obstetricians can perform this test themselves. Usually, an experienced ultrasound technician, or ultrasonographer, performs the test. A cardiologist who specializes in pediatric medicine will then review the results after your test is finished.
You don’t need to do anything to prepare for this test. Unlike other prenatal ultrasounds, you won’t need to have a full bladder for the test.
The test can take anywhere from 30 minutes to two hours.
This test is similar to a routine pregnancy ultrasound. If it’s performed through your abdomen, it’s called an abdominal echocardiography. If it’s performed through your vagina, it’s called a transvaginal echocardiography.
An abdominal echocardiography is very much like an ultrasound. You’ll 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 that the ultrasound transducer, which is a device that sends and receives sound waves, can be rubbed 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 unborn child’s heart. Those echoes are then reflected back into a computer. The sound waves are too high-pitched for the human ear to hear.
The technician will move the transducer all around your stomach to get images of different parts of your baby’s heart.
After the procedure, the gel will be cleaned off your abdomen. You can then continue with your normal activities.
For a transvaginal echocardiography, you’ll be asked 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. It may provide a clearer image of the fetal heart.
There are no risks associated with the echocardiogram because it uses ultrasound technology and no radiation.
During your follow-up appointment, your doctor will explain the results to you, answer any questions you might have, and refer you to any appropriate resources or specialists needed to treat your unborn child’s condition.
Generally, normal results mean that no cardiac abnormality was found. If your doctor 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. You may also need to have this test done more than once or go in for additional testing if your doctor thinks something else could be wrong.
It’s important to remember that an echocardiography can’t always be used to diagnose every condition. Some problems, such as a hole in the heart, are difficult to see even with advanced equipment. Your doctor will explain what the test can and cannot diagnose.
Abnormal results from a fetal echocardiography can be inconclusive or require that you get more testing to figure out what might be wrong. Once a diagnosis is determined, you can better manage your pregnancy and prepare for delivery. Information from this test will 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.