Understanding Fetal Echocardiography

Fetal echocardiography is a specialized ultrasound that evaluates the structure, function, and rhythm of a baby’s heart while still in the womb. This scan uses high-frequency sound waves to create detailed images of the fetal heart, aiding in the detection of congenital heart defects (CHDs) and other abnormalities.

How is Fetal Echocardiography Different from Other Scans?

• Focus on the Heart: Unlike routine ultrasounds, this scan exclusively examines the heart's anatomy, blood flow, and rhythm.
• High Detail: It uses advanced imaging techniques such as Doppler ultrasound to observe blood flow through the heart and its valves.
• Specialized Equipment and Expertise: Fetal echocardiography provides enhanced resolution to detect minute structural and functional details that routine anatomy scans may miss.

Why Does This Scan Require a Specialist?

Fetal echocardiography is typically performed by a fetal medicine specialist, pediatric cardiologist, or a specialist trained in fetal echocardiography because:

• Congenital heart defects are complex and require expertise for accurate interpretation.
• Identifying heart abnormalities demands a deep understanding of embryology, cardiac anatomy, and physiology.
• Specialists ensure precise evaluation to guide further interventions or treatment plans.

Is Fetal Echo a Routine Scan or Case-Specific?

This scan is not routinely recommended for all pregnancies. It is primarily advised in specific circumstances, including:

• High-Risk Pregnancies: Maternal diabetes, autoimmune conditions (e.g., lupus), or certain infections like rubella.
• Family History of CHDs: A previous child with CHD or a family history of genetic conditions linked to heart defects.
• Abnormal Findings in Routine Scans: If the anatomy scan reveals signs like abnormal heart rhythms, fluid accumulation, or other concerning markers.
• Assisted Conception: Pregnancies conceived through IVF or ICSI may have a slightly higher risk of anomalies.

Who Should Undergo Fetal Echocardiography?

It is recommended for:

• Women with medical conditions like diabetes or phenylketonuria.
• Pregnancies with abnormal findings in early scans.
• Families with genetic syndromes or a history of CHDs.
• Pregnant women exposed to teratogens (e.g., certain medications or infections).

 

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What Does the Scan Look For?

Fetal echocardiography examines:

• Structural Defects: Such as septal defects (holes in the heart), valve abnormalities, and underdeveloped chambers.
• Blood Flow Patterns: Ensures proper circulation through the heart and major vessels.
• Rhythm Abnormalities: Detects irregular heartbeats or arrhythmias.
• Functional Issues: Identifies problems with the heart’s pumping efficiency.

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Abnormalities Detected by Fetal Echocardiography

The scan can identify a range of heart conditions, including:

• Septal Defects: Holes in the heart’s walls, such as atrial or ventricular septal defects.
• Outflow Tract Defects: Issues with arteries like transposition of the great arteries (TGA) or tetralogy of Fallot (TOF).
• Valve Disorders: Narrowing (stenosis) or improper opening/closing of valves.
• Arrhythmias: Irregular heartbeats or abnormal heart rates.
• Syndromic Associations: Heart issues linked to genetic syndromes like Down syndrome or Turner syndrome.

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How Early Can Abnormalities Be Detected?

Fetal echocardiography is typically performed between 18 and 24 weeks, though some abnormalities can be identified as early as 16 weeks. Early detection allows:

• Better pregnancy management.
• Preparation for postnatal surgeries or interventions.
• Delivery planning at a facility with advanced neonatal care if required.

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