Fetal Echocardiography : Purpose, Procedure and Risks Factors

Overview

Fetal echocardiography, also called a fetal echocardiogram, evaluates the baby’s heart before birth.

This blog is a comprehensive understanding of fetal echocardiography, its purpose, procedure, and risks.

What is fetal echocardiography?

Fetal echocardiography (echo) uses sound waves to examine the developing baby’s heart structure and function. Doctors usually perform fetal echocardiography between weeks 18 and 24 of the second trimester.

This test utilises sound waves that ‘echo’ the developing baby’s heart structures. These sound waves produce an image or echocardiogram of the heart’s interior to check its formation and functionality. It also allows the doctor to examine the blood flow through the developing baby’s heart. This in-depth look enables the doctor to detect abnormalities in the baby’s blood flow or heartbeat.

Why is fetal echocardiography performed?

Doctors perform fetal echocardiography to detect a heart problem before the baby is born. Fetal echocardiography can provide a more detailed image of the baby’s heart than a regular pregnancy ultrasound.

Fetal echocardiography can display the blood flow through the heart, the heart rhythm, and the structures of the baby’s heart. Doctors would perform this test if:

• The parent, sibling, or other close family members have a heart defect or suffer from heart disease.
• A routine pregnancy ultrasound detects an abnormal heart rhythm or a possible heart problem in the unborn baby.
• The pregnant woman has diabetes (before pregnancy), lupus (an autoimmune disease), or phenylketonuria.
• The expecting mother had rubella in the first trimester of pregnancy.
• Women who have used medicines such as epilepsy medication or prescription acne medication can damage the baby’s developing heart.
• An amniocentesis reveals a chromosome disorder.

What happens during fetal echocardiography?

Before the procedure

Women are not required to prepare for fetal echocardiography. Unlike other prenatal ultrasounds, women don’t need to have a full bladder for the test.

During the procedure

Fetal echocardiography is very identical to a routine pregnancy ultrasound. The procedure is performed either through the abdomen or vagina.

1. Abdominal echocardiography

Abdominal echocardiography is very identical to an ultrasound. An ultrasound technician will first ask the woman to lie down and expose their belly, after which they apply a special lubricating jelly to their skin. The jelly prevents friction so the technician can move an ultrasound transducer over the skin. It also helps in the transmission of sound waves.

An ultrasound transducer is a device that sends and receives sound waves. For abdominal echocardiography, it sends high-frequency sound waves through the woman’s body. The waves echo when they hit a dense object, such as the unborn baby’s heart. Those echoes are then displayed on a computer because the sound waves are too high-pitched for the human ear to hear.

The technician moves the transducer all around the woman’s stomach so that they obtain images of different parts of the baby’s heart.

2. Transvaginal echocardiography

For transvaginal echocardiography, women must undress from the waist down and lie on an examination table. The technician inserts a tiny probe into the woman’s vagina. The probe uses sound waves to produce an image of the baby’s heart. Doctors can perform a transvaginal ultrasound earlier in the pregnancy since it provides a clearer picture of the developing baby’s heart than an abdominal ultrasound.

After the procedure

If the results are unclear or abnormal, the doctor may prescribe further testing, including fetal wellness assessments, non stress tests, biophysical profile (BPP), and others. They may also provide medicines or perform other procedures to treat fetal heart problems. The doctors can also advise parents to undergo genetic counselling, in which a counsellor helps them learn about the risks of having a baby with congenital defects.

Are there any risks associated with fetal echocardiography?

Fetal echocardiography is not risky for the developing baby or the mother since it uses ultrasound technology and there is no involvement of radiation.

Conclusion

Fetal echocardiography lets the doctor examine the structure and function of the unborn baby’s heart. While normal results mean that there is no cardiac abnormality, abnormal results from fetal echocardiography can sometimes be inconclusive, and women can be required to undergo more tests so that the problems are diagnosed correctly. Once the doctor diagnoses a condition, women can appropriately manage their pregnancy and prepare for delivery.

Frequently Asked Questions (FAQs)

1. What do the results mean?

Normal results mean that the fetal echocardiography has not found any problems in the unborn baby’s heart. Abnormal results may indicate problems in the formation of the baby’s heart (congenital heart disease), working of the baby’s heart, and heart rhythm disturbances (arrhythmias). 

2. How long does fetal echocardiography take?

Obtaining the pictures required to examine all the heart parts can take 30 minutes to 2 hours. Sometimes, the baby’s position can make it challenging for doctors to examine the heart, and the test takes a lot of time.

3. How will women feel during fetal echocardiography?

The lubricating gel that is applied may feel slightly cold and wet. However, women will not feel the ultrasound waves.