What is fetal echocardiography?

Fetal echocardiography (echo) uses sound waves to check the heart of your developing baby.

Fetal echo can help find heart defects before birth. If a heart problem can be found early, the more likely treatment will work. This is because:

• Healthcare providers may be able to treat the problem before birth, in some cases. 

• Healthcare providers can get ready for problems that may happen during labor and delivery. 

• An early delivery can be scheduled.

• Once the baby is born, treatment may be done. This might be medicine or surgery.

Why might I need fetal echo?

Healthcare providers advise fetal echo in these cases:

• Another child was born with a heart defect

• Family history of genetic heart problems

• Genetic problem found in the fetus

• You are taking certain medicines that may cause congenital heart defects. These include certain medicines for seizures, depression, and acne. They also include nonsteroidal anti-inflammatory medicines (NSAIDs) and blood pressure medicines (ACE-inhibitors).

• You have abused alcohol or drugs during your pregnancy

• You have certain health problems, such as diabetes, lupus, or phenylketonuria

• You have had certain infections during your pregnancy. These include German measles (rubella) or cytomegalovirus.

• You had abnormal test results from other tests

• You conceived by assisted reproductive technology

• Your baby was noted to have too fast, slow, or irregular heartbeats on exam

• Abnormalities seen on fetal ultrasound

• You became pregnant at an advanced age

If you have risk factors, such as a family history of heart problems, fetal echoes are often done in the second trimester of pregnancy. This is at about 18 to 24 weeks.

What are the risks of fetal echo?

Fetal echo does not have any risks for either the baby or mother. The lowest possible ultrasound settings are used.

How do I get ready for fetal echo?

You don't need to do anything to get ready for fetal echo. Plan for 30 minutes to 2 hours for the test.

What happens during fetal echo?

A specially trained pediatric cardiologist, maternal-fetal medicine specialist, obstetrician, or radiologist does fetal echo. In general, the steps include:

• You will lie on an exam table. You won’t likely need to change your clothes. 

• The healthcare provider will put gel on your belly. 

• The provider will use a handheld electronic device called a transducer that sends out sound waves. 

• They will move the transducer around to get the best images of the fetal heart. You may feel pressure as the transducer moves over your belly.

• Once the exam is complete, the gel is wiped off. 

Sometimes an endovaginal echocardiogram is done early in pregnancy to monitor the developing baby's heartbeat. The provider puts a small echocardiogram probe into the vagina instead of putting it on the belly.

What happens after fetal echo?

Your healthcare provider will look at the results. You may need more tests or procedures. They may include:

• Treatment. This may be medicine or procedures to treat fetal heart problems.

• Fetal wellness assessments. To check overall fetal health, you may be asked to count fetal movements.

• Nonstress test. This checks fetal heart rate and movement.

• Biophysical profile (BPP). This is an ultrasound exam to check overall fetal health. It checks heart rate, breathing, movement, muscle tone, and the amount of amniotic fluid.

• Ultrasounds or echocardiography. These are tests done to confirm the diagnosis. They also follow fetal growth, watch for fetal heart changes, and check for other problems.

• Amniocentesis. This test can find chromosomal and genetic disorders and certain birth defects. The healthcare provider puts a needle through the abdominal and uterine wall and into the amniotic sac. They take a sample of amniotic fluid.

• Genetic counseling. A counselor helps you learn your risks of having a baby with genetic defects.

Next steps

Before you agree to the test or procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure