Cardiology/Heart Disease
Fetal Echocardiography
The Pediatric Cardiovascular Services at the NewYork-Presbyterian Komansky Center for Children’s Health offers state-of-the-art digital echocardiography that includes:
- fetal echocardiography
- three-dimensional echocardiography
Fetal echocardiography has been around for many years. But the technology for this non-invasive test – which uses sound waves to reveal the structure and functioning of an unborn baby’s heart – has significantly improved since it was first introduced.
When is this test necessary?
If an obstetrician identifies a possible heart abnormality in the fetus during a routine ultrasound or if there is a problem getting a clear image of the heart, the patient is referred to a cardiologist for a fetal echocardiograph. The test can also be necessary for several other reasons. For example, if:
- there is a family history of congenital heart disease
- the mother has taken certain medications that could cause congenital heart disease
- it has been discovered that the fetus has a genetic or chromosomal abnormality
- the mother has consumed alcohol or used drugs during pregnancy
- the mother has diabetes, phenylketonuria, or a connective tissue disease, or had rubella during the pregnancy
How early in the pregnancy should it be performed?
The optimal time for a fetal echocardiograph is between the 19th and 24th week of pregnancy. It can be performed earlier, but the small size of the fetus makes it more difficult to get a good image of the heart.
How is a fetal echocardiograph performed?
A pediatric cardiologist usually performs a fetal echocardiograph, using one of the following methods:
Abdominal Ultrasound – a gel is applied to the abdomen and the physician glides the ultrasound transducer glides over the abdomen to create the image.
Transvaginal Ultrasound – a smaller ultrasound transducer is inserted into the vagina and rests against the back of the vagina to create an image. This type of ultrasound produces a sharper image than abdominal ultrasound and is often used in early pregnancy.
What happens if a heart problem is detected?
The good news is that a majority of the fetal echocardiography tests reveal normal fetal hearts. But if there is a congenital heart defect, the fetal echocardiograph usually reveals it – although there are a few heart abnormalities that cannot be detected before birth, including minor abnormalities that are related to changes in fetal circulation that occur at the time of birth.
If a heart defect is detected, the cardiologist who performed the fetal echocardiograph immediately begins coordinating care. That physician works closely with a surgical team – if surgery is necessary—and other specialists, including neonatologists, who are the primary care team for newborns. From the moment of diagnosis until the birth of the baby, the family receives extensive counseling so they understand each step of the treatment process. In addition, specialists in maternal fetal medicine, neonatology, cardiology, and cardiac surgery meet monthly to review cases of patients who are expected to deliver babies with congenital heart problems within the next few months to ensure that everyone is prepared for the birth and details of the intervention plans.
Although most congenital heart defects spotted by the fetal echocardiography require treatment after the baby’s birth, fetal arrhythmias can be treated during the pregnancy. An anti-arrhythmic medication is prescribed for the pregnant patient in order to manage the fetal arrhythmias. But, again, this is a rare instance where an intervention is possible before the birth.
Scheduling a Fetal Echocardiograph
If you would like to schedule a fetal echocardiograph, you can self-refer or be referred by your obstetrician.
For more information or to make an appointment please call:
212-746-3561.
