What To Know About Fetal Echocardiograms

Posted On: July 16, 2021 By Jennifer Lam-Rachlin, MD

If your doctor orders a fetal echocardiogram (often called “fetal echo”), you likely have nothing to worry about. This procedure, which uses ultrasound imaging to map the fetal heart, is used to detect congenital heart defects, which occur in about 1% of births. About 1 in 4 babies born with a heart defect has a critical congenital heart defect which require surgery or other procedures in the first year of life. However, the vast majority of these defects are non-critical, meaning the prognosis is very good and there is no need for surgery. 

Mapping The Fetal Heart 

One of the main functions of the heart is to transport oxygen throughout the body.  After delivery, the oxygen is supplied by the lungs, whereas in a fetus, oxygen is supplied through the umbilical cord which Dr. Jennifer Lam-Rachlin explains the difference in blood flow within the fetal heart compared to the newborn and adult heart. This makes a fetal heart “a complicated structure, but it also makes a lot of sense,” according to Dr. Lam-Rachlin. 

When Are Fetal Echoes Taken? 

Doctors may request fetal echocardiograms for several reasons, most commonly if a patient has an elevated risk for congenital heart defects. Additionally, fetal echoes can be taken to simply get a better picture of the heart when routine screening didn’t provide enough visualization. 

What Are Congenital Heart Defects? 

Dr. Lam-Rachlin says that congenital heart defects are the most common type of birth defect. It includes structural problems with the heart as well as heart rhythm issues, where the electrical stimulation is abnormal. These defects can cause serious complications if not addressed immediately after birth, and is one of the leading causes of neonatal death. This is why it’s important to understand exactly what’s going on in a fetal heart prior to birth—as early as possible to determine the appropriate treatment. 

Benefits of Fetal Echocardiograms 

The main benefit of fetal echoes is that they allow doctors and patients alike to plan ahead and be ready for anything when it comes time to give birth.  Most prenatally identified congenital heart defects will not be repaired until after delivery therefore overall pregnancy care and delivery will not be altered. However, in cases where fetal echoes do reveal a potential issue, this allows doctors to identify exactly what will be needed after birth for the specific type of defect. This includes planning after-birth treatments or surgeries as well as medical specialists who may need to be on hand. 

As Dr. Nathan Fox says, “it can’t be overstated how important [early diagnosis] is. I mean, the difference between a baby that’s born with a heart defect that’s anticipated and known about in advance versus the baby that’s born with a heart defect that is discovered after birth, particularly a major one that’s going to require some sort of surgery or treatment, it’s night and day.” 

Knowing about potential issues ahead of time also allows patients to emotionally come to terms with the prognosis, allowing for clearer heads when given weeks, not hours, to make crucial decisions about the baby’s care after birth. 

Risk Factors for Congenital Heart Defects 

Generally speaking, a congenital heart defect can impact any pregnancy, regardless of having specific risk factors. However, Dr. Lam-Rachlin says that the most common risk factor is “if the patient themselves were born with a congenital heart disease, or their spouse was born with a congenital heart disease,” or when a previous child had a heart defect. In these cases, a fetal echo will likely be taken to better understand the condition of the fetal heart. 

Other risk factors include high-risk categories such as diabetes or IVF pregnancies, although the increase in risk compared to the general likelihood of it occurring is a minor one. 

Fetal Heart Imaging Experts in New York City 

Fetal echocardiograms are a vital tool in diagnosing a relatively common and sometimes serious condition in babies. And getting an accurate diagnosis relies on both the tool and the doctor using it. At Carnegie Imaging for Women, our maternal fetal medicine specialists won’t rest until they’re certain of the results of your ultrasound tests. No pregnancy is routine, and we won’t treat yours like it is. To learn more about our services and how we can be your partner in health during your pregnancy, call our office or fill out a contact form online today. 

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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