Center for Perinatal Care
American Family Children's Hospital
POD2 and specify fetal echocardiogram
When necessary, pediatric cardiologists from the American Family Children's Hospital Pediatric Cardiology Clinic in Madison, Wisconsin, conduct a fetal echocardiography test for women at an increased risk of giving birth to a baby with congenital heart disease.
Fetal echocardiography involves a detailed ultrasound of the baby's heart before birth. This allows a fetal cardiologist to evaluate the baby's heart. It allows heart defects to be diagnosed before birth as well as evaluation of heart function and abnormal heart rhythms.
Congenital heart defects (or birth defects of the heart), as a group, are the most common type of birth defect. They occur in about 1 percent of the population. Many of these will not make a baby sick, but some are very complex.
Some of these complex congenital heart defects are poorly tolerated by the newborn baby after birth, due to changes in blood flow patterns and can cause heart failure (inability of the heart to pump blood to the body) or cyanosis (blueness due to low oxygen in blood). If these types of heart problems are not diagnosed shortly after birth, they can be a medical emergency in these newborn babies.
Prenatal (before birth) diagnosis of complex heart defects allows time for the family to gather information and for the team to plan a safe delivery and plan medications and procedures to help keep connections open in the baby's heart, which help keep the baby more healthy until surgery. In addition, some types of heart rhythm abnormalities in the baby, including very slow (bradycardia) as well as rapid heart rhythm (tachycardia) can be detected and managed before birth with medications given to the mother, allowing for the pregnancy to continue and the baby to be safely delivered.
The American Family Children's Hospital fetal cardiology program is staffed by dedicated fetal cardiologists with special training in assessment of your baby's heart with ultrasound, called fetal echocardiography. These doctors are also experts in the management of heart conditions in the baby before birth. Your fetal cardiologist will help explain cardiac concerns in your baby and help put together a care plan for your baby during your pregnancy and around the time of birth.
This level of care needs a multidisciplinary approach. Members of your team include perinatologists doctors who specialize in complex, high risk pregnancies), your primary doctor, neonatologists (specialists who take care of newborn babies) as well as genetic counsellors, and specialized nurse coordinators. All of these providers help families with their medical needs as well as emotional support. They all provide comprehensive care for the mother as well as baby. If needed, prenatal cardiac surgical or interventional cardiology consultation helps families meet with the surgeon or interventional cardiologist before the birth of their baby to ask questions and understand planned procedures.
Fetal echocardiography services are available both at the Perinatal Imaging Center at Meriter Hospital, as well as the pediatric cardiology clinic at the American Family Children's Hospital.
Specialized ultrasound evaluation of a baby's heart before birth that helps look at the structure of the heart as well as its function and rhythm (heart beat). A special ultrasound transducer placed on the pregnant women's abdomen or belly helps create pictures of the heart valves and heart with the use of sound waves.
Indications: Who should have a fetal echocardiogram?
Women at an increased risk of giving birth to baby with congenital heart disease.
Risk factors include:
- A family history of congenital heart disease in a first degree relative (parent or sibling)
- An abnormal fetal heart rhythm
- Concern for a fetal heart abnormality during a routine pregnancy ultrasound scan
- Abnormality of another major organ system
- Maternal conditions such as Insulin-dependent (type 1) diabetes mellitus, phenylketonuria or Systemic Lupus Erythematosis
- Exposure to certain drugs in early pregnancy (examples include some anti-epileptic drugs, Accutane®, or mood stabilizing medications)
- Abnormal amniocentesis
- Chromosomal abnormalities in the unborn baby
When can the test be performed?
Beginning at 14 weeks gestation, an echocardiography can be performed by scanning through the vagina. Starting around 18 weeks gestation, imaging is done through the abdomen.
What does the test detect?
A fetal echocardiogram can detect:
- Abnormalities of cardiac structure or congenital heart defects
- Arrhythmias, or cardiac rhythm disturbances
- Problems with heart function
What are some problems that a fetal echocardiogram won't detect?
A fetal echocardiogram is focused on the baby's heart and will not detect problems with other organ systems. It cannot detect all heart abnormalities. Some problems such as small holes in the heart, minor valve problems may be missed. Some heart defects cannot be detected before birth due to the difference in blood flow patterns before birth or may develop later in the pregnancy and so may be missed on a fetal echocardiogram done earlier. Your fetal cardiologist will discuss findings and limitations with you.
What do the results of the test mean?
Your fetal cardiologist will discuss the test results with you in detail after the scan. A normal scan provides reassurance. Heart defects or variations in scan will be discussed with you by your fetal cardiologist and recommendations made for evaluation of the baby after birth, if needed. If a complex congenital defect is found, a multidisciplinary team will help manage your pregnancy needs and care of the baby through the pregnancy and after birth. Repeat ultrasounds to monitor growth of the baby and baby's heart are often recommended in these cases.
Fetal Cardiology Providers
Pediatric Cardiothoracic Surgery