Fetal echocardiography: what is it and what is it for to study the heart of the fetus

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What is it for

In the event that there is a suspicion of congenital heart disease or other cardiac malformations, undergoing an examination such as fetal echocardiography is important because it allows us to have clear answers already starting from the observation of the uterus and to understand how to act after childbirth through the instructions of the doctor, who can decide if necessary to intervene with surgical therapies or medicines. Otherwise, without this information, the risk of criticality during and after childbirth could increase significantly.

It is mandatory?

Fetal echocardiography is not one of the mandatory tests to be performed during pregnancy. However, it is recommended by the gynecologist when, following the morphological ultrasound, some abnormalities and risk factors are found with respect to the anatomy and functioning of the fetal heart. Therefore, the woman undergoes this examination to clarify any doubts and to have precise information regarding the state of health of the fetus. In general, fetal echocardiography is mandatory in these cases:

• Maternal or family indications: hereditary diseases, congenital heart disease in the family, diabetes, autoimmune diseases, the pregnant woman taking drugs with lithium, alcohol and anticonvulsants, infections contracted during pregnancy (toxoplasmosis, rubella, cytomegalovirus, parvovirus B19 etc.)
• Fetal indications: suspected malformations in the fetal heart, chromosomal abnormalities, elevated nuchal translucency at first trimester screening, early growth failure, repeated heart arrhythmias, abnormal fetal karyotype.

When to do it

Usually, an examination such as fetal echocardiography, to be as precise as possible, should be performed no earlier than the 20th week of pregnancy. However, there are certain cases in which it is essential to intervene as soon as possible and to resort to an early test starting from the 16th / 17th week. The urgency of an early prenatal diagnosis occurs especially in the presence of high risk factors such as in the case where the mother has already given birth to another child with congenital heart disease.

How fetal echocardiography is performed

Fetal echocardiography is performed in medical clinics where you can count on high-performance ultrasound scanners and the expertise of trained and experienced operators. In detail, this is how this test takes place: the pregnant woman is made to lie on the bed in a supine position and on the abdomen, previously covered with gel, a high-frequency probe is passed to conduct a detailed study of the anatomical structures of the heart fetal (heart chambers, atrio-ventricular and ventricular-arterial connections), then we move on to the use of pulsed color doppler to get a clearer picture about the circulation in the heart and great vessels and the venous flow in the umbilical cord. To obtain the definitive diagnosis, the report is entrusted to the gynecologist or the cardiologist Pedriata, the only figures who have the necessary means to interpret it and provide the pregnant woman with the information she needs.

Is it reliable?

As for the reliability of the exam, fetal echocardiography is 90% safe. If the test is performed early, it is advisable to undergo it again after the 20th week, when the heart and other organs of the fetus are more developed and allow for a more detailed study. Instead, in the case of more obvious risk factors and rather serious malformations, it is advisable to repeat the examination once a month. However, there are some cases in which fetal echocardiography may be less reliable, for example when there is a fat concentration in the maternal abdomen (obesity), or when the baby is in an unsuitable fetal position. Sometimes, in the best of cases, it can happen that the danger of small heart problems re-enters autonomously during pregnancy so as to deny the prenatal diagnosis at the time of delivery.

Does fetal echocardiography have any contraindications?

Echocardiography does not present any contraindications. It is a totally painless test and uses sound waves like any ultrasound.

How long does it last?

The duration of this exam is usually around 30/35 minutes.

How much?

On average, undergoing a fetal ultrasound can cost between 80 and 200 euros. The figure may change depending on the city or the diagnostic study to which you decide to contact, however there are exceptions that provide for the exemption for this type of ultrasound: for example, in the event that there have been previous cases of congenital heart disease in the family, the expectant mother has started to suffer from certain diseases during pregnancy or has taken medicines that are potentially dangerous for the fetus.