The test is sometimes done earlier in pregnancy using transvaginal ultrasound the ultrasound probe is inserted in the mother's vagina , but will be repeated later to confirm any findings. A fetal echocardiogram is performed by a pediatric cardiologist or a maternal fetal specialist also called a perinatologist who is specially trained.
The test may be done using an abdominal or transvaginal ultrasound. During the test, the transducer probe will be moved around to obtain images of different locations and structures of the fetal heart. Techniques sometimes used to obtain detailed information about the fetal heart include:. For Patients. Fetal Echocardiography In-Depth. What is fetal echocardiography?
How does a fetal echocardiogram work? A small probe called a transducer similar to a microphone is placed on the mother's abdomen and sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed in certain locations and at certain angles, the sound waves move through the mother's and baby's skin to the baby's heart tissues, where the waves bounce or "echo" off of the heart structures.
The transducer picks up the reflected waves and sends them to a computer. The computer interprets the echoes into an image of the heart walls and valves. Some problems such as maternal lupus require several studies even if the first one is normal. There also may be a structure that is not seen as well as the doctor would like, and you may be asked to return even though the suspicion of a problem is low.
Even in the case of a totally normal, high quality study, you will be counseled that not all heart problems can be ruled out. This is because the circulation in the fetus is different than after birth. Additionally, very small holes between the lower chambers of the heart are hard to see. However, considering the normal fetal circulation, you doctor can provide fairly definitive good news in the case of a normal fetal echocardiogram.
Fetal echocardiograms can reliably be performed any time after 17—18 weeks gestation; however, newer technology including endovaginal transducers can obtain images of the heart as early as 12 weeks.
If scanning is done before 18 weeks, you will likely be asked to return for more definitive pictures to confirm the findings on the early study. In some cases 18 weeks is still too early. When a heart defect is found, the pediatric cardiologist will explain in detail the diagnosis and implications as soon as the study is completed.
In most cases the doctor may take additional pictures after the sonographer has completed the initial study. The pediatric cardiologist will likely provide and draw pictures to explain the significance of the heart defect including whether or not the defect will affect the fetus prior to birth, require immediate transfer after birth, and need heart surgery after birth.
In almost all cases you will be asked to return for follow up fetal echocardiograms to obtain more information as you prepare for delivery. Your pediatric cardiologist will give you as much information as possible and also inform you of what questions still remain. Your future visits may include meeting with a cardiac surgeon or interventional cardiologist to learn more about heart surgery or other procedures after birth.
The diagnosis of heart defect has significant implications for the overall health of the fetus; certain heart defects may significantly increase the risk of genetic problems such as Down Syndrome or DiGeorge Syndrome. The finding of benign tumors in the heart makes the diagnosis of Tuberous Sclerosis, a genetic syndrome that has significant implications for abnormal brain development much more likely.
These issues may have significant implications on the prognosis of the child and play a major role in helping you make decisions about your pregnancy. Your cardiologist will provide you with information about whether or not you need to worry about these other issues; however, when the concern is significant you will be referred to other members of the care team that work closely with the pediatric cardiologist.
You don't need to do anything to get ready for fetal echo. Plan for 30 minutes to 2 hours for the test. A specially trained pediatric cardiologist, maternal-fetal medicine specialist, obstetrician, or radiologist does fetal echo.
In general, the steps include:. He or she 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. Sometimes an endo-vaginal echocardiogram is done early in pregnancy to monitor the developing fetus' heartbeat. The healthcare provider puts a small echocardiogram probe into the vagina instead of putting it on the belly.
Your healthcare provider will look at the results. He or she may order more tests or procedures. They may include:.
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