It is now possible to detect congenital heart diseases in the fetus with remarkable treatment to the critical heart lesions within the womb. When a routine ultrasound is performed during pregnancy, then a four-chamber view of a fetal heart is performed. However, a four-chamber view of fetal heart does not detect conotruncal abnormalities.
The patients with any risk factor for congenital heart disease should be referred for a detailed fetal echocardiographic study.
Indications for fetal echocardiogram
- Abnormal appearing heart on general fetal ultrasound
- Fetal tachycardia, bradycardia, or persistent irregular rhythm on clinical or screening ultrasound examination
- Maternal or family risk factors for cardiovascular disease, such as parent sibling, or first relative with congenital heart disease
- Maternal diabetes mellitus
- Maternal Systemic lupus erythmatosus
- Teratogen/ Drugs exposure during vulnerable period
- Other fetal organ system anomalies detected in fetus (including chromosomal)
- Performance of transplacental therapy or presence of a history of significant but intermittent arrhythmia. In such conditions, reevaluation examinations are required
- Fetal distress or ventricular dysfunction of unclear etiology
- Possible indications for fetal echocardiogram
- Previous history of multiple fetal losses
When to do Fetal Echocardiogram?
Fetal echocardiogram is ideally done at 18-20 weeks of gestation. Repeat examination can also be conducted before 22 weeks (maximum time limit of termination of pregnancy) if the first examination is incomplete.
Dr. Neeraj Awasthy says, Serial examinations are recommended if any cardiac defect is witnessed and still pregnancy is continued. Fetal echocardiography has been reported to have a high accuracy if it is performed by experienced individuals. It is an extremely safe procedure with no radiation involved.
Due to the increasing advancements in scientific technology, not only the illness can be diagnosed in the womb, but the certain critical illness like narrowing of valve: aortic and pulmonary can also be detected.
These lesions if detected and treated well in time prevents the progression of the fetus to hypoplastic left heart or hypoplastic right heart syndrome (both with very poor long-term outcome).
Can Fetal Echocardiogram detect other diseases?
Yes, other cardiac diseases which can be treated in utero include restricted PFO and intractable fetal arrhythmias. However, it is important to recognize these lesions timely so that appropriate therapy if timely instituted within the mother’s womb can deliver a healthy baby.