Fetal Cardiac Care

A simple guide for parents

A fetal echocardiogram (fetal echo) is a specialised ultrasound that looks closely at your baby’s heart. Choosing the right time for this test helps doctors get the best possible picture and gives you clear guidance.

The Best Time for a Fetal Echo: 18–22 Weeks

Most parents will have their fetal echo between 18 and 22 weeks of pregnancy.

This is the ideal time because:

• Your baby’s heart is the right size to see all the major structures clearly.
• The chest bones are still soft, so images are clearer.
• The baby’s position is usually stable enough for the doctor to capture all key views.
• Most heart problems, if present, can be diagnosed at this stage.
• This timing allows enough space for counselling, follow-up and decision-making.

Why Some Need an Earlier Scan

A fetal echo can also be done earlier (around 11–16 weeks) if:

• There was an abnormal finding on the first-trimester ultrasound,
• The baby has a higher chance of heart problems,
• There is a family history of congenital heart disease.

Important:

An early scan often needs a repeat fetal echo at 18–22 weeks, because some heart structures develop later.

Transvaginal Fetal Echo

Sometimes, especially in early pregnancy, the doctor may suggest a transvaginal scan (through the vagina instead of over the tummy).

This helps get clearer images when the baby is still very small.

Why Timing Matters for Decision-Making

If a major heart problem is found, parents naturally think about:

• Treatment plans,
• Delivery planning,
• And whether they wish to continue the pregnancy.

Every country has its own legal rules and timelines for these decisions.

In India, these decisions follow the MTP Act, which has specific gestational limits.

So doctors aim to make a clear and confident diagnosis early, so that all options remain open for the family.

Do We Need Any Other Tests?

Sometimes, the doctor may recommend genetic tests, depending on what they see on the scan.

Some tests come back in a few days, while others take 1–3 weeks.

When a Repeat Scan Is Needed

A follow-up fetal echo may be planned if:

• The early scan was too early to be fully sure,
• Some heart conditions need time to show up clearly,
• Or the doctor wants to track the baby’s heart through pregnancy.

In Summary

Best time for fetal echo: 18–22 weeks

Repeat scans help track conditions that change over time

Earlier scans: for high-risk pregnancies, but always followed by the main scan

Clear diagnosis early = more choices for families

Local laws (like the MTP Act in India) guide decision-making if a serious problem is found