Fetal Echocardiogram FAQ's

What is a fetal echocardiogram ("fetal echo")?

A fetal echo as a special ultrasound that evaluates a baby’s heart anatomy and heart rhythm in detail. 

Who should have a fetal echo?

Your obstetrician will decide if you need to have a fetal echo. In general, mother's who are at increased risk for having a baby with a heart abnormality should have a fetal echo. Some of the risk factors are... 

  • A question of a heart abnormality on a routine ultrasound 
  • When the babies heart rate is too fast, too slow, or irregular 
  • A family history of a congenital heart defect 
  • A maternal illness such as diabetes or phenylketonuria 
  • Certain maternal viral infection such as rubella, toxoplasmosis, CMV, or others 
  • When the mother has a connective tissue disorder, such as lupus 
  • Certain medications or drugs taken by the mother, such as antiseizure medicines, lithium, indomethacin, alcohol, amphetamines, cocaine, some antidepressants, and others 
  • When an obstetric ultrasound detects abnormalities and other organs 
  • When there is increased likelihood of a genetic syndrome, such as Down syndrome, and the baby 
  • When the baby is found to have heart failure on a routine ultrasound, or is not doing well for unclear reasons 

When should my fetal echo be performed?

The baby’s heart can be evaluated as early as 16 weeks gestation, or anytime after that. It is useful to wait until 20-24 weeks, when the resolution of the echo may be improved. 

How accurate is a fetal echo?

In general, fetal echos are very accurate, and can detect nearly all forms of heart disease, including most major heart defects. However, because fetal circulation is different from the baby's 

circulation after birth, a few defects may not be found until after the baby is born. Also, some minor defects may not be detected on a fetal ago. The accuracy of the echo is also very dependent on the image quality, movement of the baby, and the baby's position in the uterus. 

Will the fetal echo hurt my baby?

There has been no evidence to suggest that the ultrasound energy used in a fetal echo can be harmful to babies. 

Who performs the fetal echo?

A sonographer who is specially trained and certified in fetal echocardiography will perform the echo. The sonographer will evaluate all of the heart chambers, valves, and blood vessels leaving the heart. He/she will also evaluate the baby’s heart rhythm. 

How long does a fetal echo take?

On average, a fetal echo takes 30-60 minutes, but it can also take longer.  The time needed is highly variable, and depends on the quality of the images that can be obtained, activity of the baby, and the complexity of the findings.  

What if there is an abnormality?

Heart defects occur in almost 1% of children. Many of these defects are minor and did not require treatment. Other defects require treatment such as medication or surgery. The pediatric cardiologist will discuss the results of the echo with you and inform you of any treatment options. The pediatric cardiologist will also work closely with your obstetrician to make plans for safe delivery of the baby, or to provide intervention during the pregnancy if needed.