FETAL ECHOCARDIOGRAPHY

What is fetal echocardiography?

Fetal echocardiography is the noninvasive ultrasound imaging of the fetal heart which involves two dimensional imaging as well as colour and spectral Doppler. It is the primary tool for prenatal detection and diagnosis of heart diseases including arrhythmias.

What are the indications for this test?

Maternal indications	Fetal indications
Family history of congenital heart disease Metabolic diseases like diabetes Exposure to drugs in early pregnancy like ibuprofen, indomethacin, salicylic acid, anti-epileptic drugs, lithium, warfarin, corticosteroids, antimalignancy drugs Rubella infection in early pregnancy Autoimmune diseases liked systemic lupus erythematosis, Sjogren’s syndrome Familial disorders like Marfan’s syndrome, Noonan’s syndrome. High risk pregnancy – elderly female, bad obstetric history, invitro fertilization	Increased first trimester nuchal translucency Fetal anomaly scan showing cardiac anomaly Extracardiac abnormality detected during routine obstetric ultrasonography (e.g. neural tube defects, renal abnormality) Chromosomal abnormality Abnormal fetal heart rhythm Presence of fetal hydrops Multiple gestation and suspicion of twin to twin transfusion syndrome Two vessel chord

Maternal indications

Fetal indications

Family history of congenital heart disease
Metabolic diseases like diabetes
Exposure to drugs in early pregnancy like ibuprofen, indomethacin, salicylic acid, anti-epileptic drugs, lithium, warfarin, corticosteroids, antimalignancy drugs
Rubella infection in early pregnancy
Autoimmune diseases liked systemic lupus erythematosis, Sjogren’s syndrome
Familial disorders like Marfan’s syndrome, Noonan’s syndrome.
High risk pregnancy – elderly female, bad obstetric history, invitro fertilization

Increased first trimester nuchal translucency
Fetal anomaly scan showing cardiac anomaly
Extracardiac abnormality detected during routine obstetric ultrasonography (e.g. neural tube defects, renal abnormality)
Chromosomal abnormality
Abnormal fetal heart rhythm
Presence of fetal hydrops
Multiple gestation and suspicion of twin to twin transfusion syndrome
Two vessel chord

When should this test be done?

The ideal period for screening is between 18 – 20 weeks of gestation (pregnancy).

What are the Pre-test instructions?

Patient need not be fasting and can eat and drink normal diet before the test.
Can take all the regular medications unless otherwise directed by the physician.
Bring all the prior investigations, reports and referral note along with patient.
Patient will be asked to fill the FORM F[See Proviso to Section 4(3), Rule 9(4) and Rule 10 (1A)] - Form for maintenance of record in respect of pregnant woman` by genetic clinic / ultrasound clinic / imaging centre before the test.

How is the test performed?

Patient is instructed to lie down flat on back with the abdomen uncovered. Adequate jelly is then applied to the abdominal wall followed by echocardiography of the fetal heart.

Sometimes, it becomes difficult to get the required fetal heart images in one sitting due to changing fetal position. As a result, the patient may be asked to walk about for 10 – 15 minutes and the test is repeated.

What are the risks?

There are no risks involved with the use of ultrasound waves and the transducer and there are no contraindications for this test. The test is safe for the fetus and the mother.

What happens after the test?

Patient can carry out all her regular activities and take her medicines as per her routine.