When Is a Fetal Echocardiography Advised?

A quick guide for expectant parents

What Is a Fetal Echocardiography?

A fetal echocardiography (or fetal echo) is a detailed ultrasound that looks closely at your baby’s heart — its structure, rhythm, and blood flow. It is safe, non-invasive, and done through your tummy, just like a regular pregnancy scan. It helps your doctor ensure that your baby’s heart is developing and functioning normally.

When a Fetal Echo Is Recommended

1️⃣ Maternal Reasons (Mother’s Health)

• Diabetes before pregnancy
• Autoimmune antibodies (anti-Ro / anti-La)
• A known heart condition
• Certain medications that may affect the baby’s heart
• Infections in early pregnancy (like rubella or parvovirus)
• Conceived through IVF or ICSI

2️⃣ Fetal Reasons (Baby’s Scan Findings)

• Unusual heart appearance or rhythm
• Increased neck thickness (NT)
• Fluid around the baby (hydrops or effusion)
• Growth restriction (baby smaller than expected)
• Twin pregnancy with shared placenta (TTTS / TRAP)
• Unclear or abnormal heart view during regular ultrasound

3️⃣ Family or Genetic Reasons

• A previous child had a heart defect
• One parent has congenital heart disease
• Chromosomal or genetic findings (like Down syndrome, 22q11 deletion) are present

4️⃣ Functional (Heart Performance) Reasons

• To assess heart strength and pumping (cardiac output)
• To measure heart function (ventricular performance, MPI)
• To study blood flow through key vessels (Doppler studies)
• To look for early signs of heart strain or fluid build-up
• To follow-up after fetal therapy or transfusion

5️⃣ Parental Request or Reassurance

• Some parents choose a fetal echocardiography for reassurance — to know the baby’s heart is healthy, especially after a previous stressful pregnancy or uncertain ultrasound. It’s completely reasonable and safe after counseling.

6️⃣ No Risk Factors but Clinical Concern

• Even in normal pregnancies, congenital heart disease (CHD) can occasionally occur. If the sonographer feels the heart view is limited or uncertain, a fetal echo may still be suggested — simply to ensure nothing important is missed.

When Is the Right Time?

The best time for a detailed fetal echocardiography is between 18 and 22 weeks of pregnancy. In higher-risk cases, it can be done earlier (around 14–16 weeks) and repeated later if needed.

Key Message

Fetal echocardiography helps detect heart conditions early and gives peace of mind when everything is normal. It is safe, informative, and an important part of caring for your baby’s heart before birth.

It’s not only about finding problems — it’s about reassurance and readiness.

For a detailed and comprehensive list of fetal echocardiography indications, and for professional reference, click here →