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How is echocardiography done in the fetus?

• Dr. Saeed Bitarafan
• September 3, 2025 Fetal echocardiography does not pose any risk to the child or mother, and the procedure is simple and does not require special care.

  Methods of performing fetal echocardiogram

  Fetal echocardiography is performed by a pediatric heart specialist and the images are interpreted by the same pediatric heart specialist who specializes in fetal congenital heart disease. Limited evaluation of the fetal heart is possible during regular obstetric scans and is appropriate for low-risk women. However, women who have one of the high risk factors for congenital heart disease should have a detailed fetal echocardiogram performed by a pediatric heart specialist.

  There are two ways to perform a fetal echocardiogram:

  1- Abdominal ultrasound

  This method is the most common form of ultrasound to evaluate the baby's heart. Gel is applied to the mother's abdomen, the ultrasound probe is gently placed on the mother's abdomen, and imaging is performed. This test is not painful and does not cause any harm to the baby. This test takes an average of 30 to 120 minutes depending on the complexity of the baby's heart.

  2- Vaginal ultrasound

  This ultrasound is usually used in early pregnancy. A small ultrasound transducer is inserted into the vagina and placed behind the vagina. Then the baby's heart can be imaged.

  

  Commentary Fetal heart echo answer

  Explanation about fetal heart echo results

  Fetal heart echo results depend on factors such as device settings, gestational age, quality of images and doctor's experience. If this is done by a pediatric cardiologist, the results will usually be explained to you immediately after the test is finished. If the initial echo is performed by a perinatologist and a heart problem is seen, you will be referred to a pediatric cardiologist for a more detailed examination. If the result is normal, depending on the circumstances, you may be discharged there or you may need to repeat the test again before or after birth. For some conditions, such as maternal lupus, it is necessary to repeat the test several times, even with a normal result. Sometimes the quality of the image is not enough and you will be asked to do the test again to be sure.

  Limitations and the right time to do an echo

  It should be noted that even a completely normal echo cannot rule out all heart problems, because the blood circulation of the fetus is different from that after birth and some small holes in the heart are difficult to see at this age. However, if the result is normal, the doctor can give you a lot of reassurance. Usually, the fetal heart echo can be safely performed from the 17th to the 18th week of pregnancy. Of course, with new devices, images can be taken even in the 12th week, but in these cases, it is necessary to repeat it again in the following weeks, so that the result can be determined more definitively.

  

  When A heart defect is diagnosed in the fetus.

  If a problem is seen in the fetal heart echo, the pediatric heart specialist will explain all the details to you after a complete examination. He usually uses pictures to show how important the heart defect is, whether it will affect the health of the fetus before birth, whether it will require immediate care after birth, or whether heart surgery will be necessary. You will almost always be asked to come in for follow-ups to get more information throughout your pregnancy. In these sessions, the doctor will answer your questions and sometimes recommend meeting with a heart surgeon or other specialist to learn more about possible treatments after birth.

  Relationship with genetic problems and parental decision-making

  Some heart problems can increase the likelihood of genetic diseases such as Down syndrome or DeGeorge syndrome. Also, the presence of benign masses in the heart can be a sign of Tuberous Sclerosis, which affects the development of the brain. These cases may have important consequences for the child's future and may even play a role in the family's decision to continue the pregnancy. In these cases, the cardiologist explains whether there is anything to worry about or not. If needed, he will refer you to other specialists of the therapy team so that a more informed and confident decision can be made.

  For more information, you can read the following article.

  Related content:

  In what cases is the fetal heart necessary?

  Not all pregnant women need a fetal echocardiogram. For most women, an early ultrasound will show the development of all four chambers of their baby's heart.

  If previous tests were inconclusive or if an abnormal heartbeat was detected in the fetus; Your gynecologist may recommend that you do a fetal echocardiogram.

  There are other cases where you may need a fetal echocardiogram, these include:

  • Your unborn child is at risk for heart abnormalities or other disorders
  • You have a family history of heart disease
  • You have already given birth to a child with heart disease
  • You have used drugs or alcohol during your pregnancy
  • have taken or been exposed to certain medications that can cause heart failure, such as epilepsy medications or prescription acne medications
  • You have other medical conditions such as rubella, type 1 diabetes, lupus, or phenylketonuria

  Fetal echocardiography should be performed by a fetal echocardiologist to review the results.

  

  care From a child with heart disease

  After birth, your baby will be under the care of a pediatric cardiologist (cardiologist). This person may be the doctor who examined you during pregnancy or another doctor who specializes in treating babies and children born with heart problems.

  Each baby's needs and treatment will be different. Your child may need the opinions of other specialists, such as nutritionists, speech therapists, and physical therapists.

  Resources:

  https://www.heart.org/en/health-topics/congenital-heart-defects/symptoms--diagnosis-of-congenital-heart-defects/fetal-echocardiogram-test

  https://www.healthline.com/health/fetal-echocardiography#preparation

  Dr. Saeed Bitrafan specialist Fetal Echo in Tehran

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  Dr. Saeed Bitarafan

  Dr. Saeed Bitarafan is a specialist in children's heart diseases, fetal echocardiography and a specialist in pediatric diseases. All articles contact us Get in touch with us

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