Fetal Echo: Purpose, Procedure & Risk Factors

In this video our SimpliHealth expert  Dr. Sandhya Dhankar  talks about the Fetal Echo Test during pregnancy. Fetal echo is an ultrasound test that is done in the second trimester during pregnancy. This test can help to hear the heart of the fetus.

What is a fetal echo?

Fetal echo (फीटल इको टेस्ट) is the test done to hear the heart of the fetus, as we do an adult echo to look at the heart in the adults. So, in the same way, it is a specialized test done to look at the fetal heart. 

When should a fetal echo be done? Or When can I hear my baby’s heartbeat?

It is usually done in the second trimester i.e. around 18 weeks onwards up to 28 weeks. So the best time to do it is around 22 weeks to 24 weeks. In India, we have this law regarding the MTP, that MTPs are usually done at 20 weeks. So we preferably do it around 18 to 20 weeks. Although the heart is still small at that time, we can still visualize the heart very well to identify the fetal heart abnormalities. And nowadays, with the advancement in ultrasound, we can look at the fetal heart around the first trimester when we do an NT scan which is around 12 -13 weeks. Major fetal heart abnormalities can be picked up as early as 12 weeks.

Do we need to be prepared for a fetal echo? Or Abdominal ultrasound prep

Usually, no special preparation is needed. One need not be fasting or have a full bladder. Sometimes we ask the pregnant women to slightly fill the bladder to look at the heart for the position of the fetus; otherwise, no special preparations are needed.

What kind of a patient especially happens to have this? Or Can heart problems affect pregnancy?

Women who have any previous history of having congenital heart disease in the family or their previous pregnancies are specially told to undergo this test. Otherwise now everybody along with the anomaly scan when we looked at different structures of the fetus we do look at the fetal heart. It is recommended to undergo fetal echo as basic views to look at the fetal heart are done along with the structure anomaly scan. If we find small abnormalities or anything which is not normal then we advise them to go for a fetal echo test.

For those babies who have any other structural abnormalities in the fetus like we have some problem with the face on the limbs or the kidneys, then we do advise them to undergo fetal echo to rule out any congenital heart disease. And mothers who have diabetes, hypertension, or any other abnormalities or they are on drugs that can lead to heart problems in the fetus, are told to undergo this special test.

What are the risk factors involved?

It is absolutely safe to do fetal echo during pregnancy. This is just the same kind of ultrasound but we have a specialized focus on the fetal heart rate, otherwise, it is the same as ultrasound. There is no radiation, it is absolutely safe to undergo fetal echo. 

Are all fetal heart abnormalities fatal? or Should I be concerned if my baby’s ultrasound shows a heart defect?

No, there are very minor abnormalities if they are detected. Simple Echogenic focus in the fetal heart or the small VSDs. VSDs are small holes in the heart. They can get corrected with time and there is no need to undergo any treatment for them. But there can be some abnormality in the fetal heart rate for which they may have to undergo an operation after birth. They can be corrected with multiple operations or maybe a single operation. 

And their abnormality is something that cannot get corrected. So that is why it is important to diagnose these abnormalities beforehand. So that the counseling of the parents can be done accordingly. Then it is up to whether they want to continue with this kind of pregnancy or they don’t want to continue. 

And sometimes the probabilities are so small that they can tell them that, it is nothing to worry about, as the baby grows this whole can be filled up. these small VSDs can get corrected as the heart develops further. 

So this test helps us to know which patients have to make the decision. If it is a major abnormality then they may have to take the decision to terminate the pregnancy. And there can be other tests that we can recommend looking at the different abnormalities in the fetus. 

Sometimes we do need to take invasive testing like amniocentesis to further diagnose the genetic abnormalities of normality of the chromosomes in the fetus.

Why fetal echo is recommended, anything else you would like to add?

I would say this fetal echo is a specialized test and should be done in those patients where it is needed.  And yes, fetal echo helps us to understand that the fetal heart rate is also a very important structure. And the abnormalities are now treated with advancements in the field of fetal medicine. Then there are different operations available in India and abroad as well so this can be corrected if the rest of the fetus is normal. They should not panic about it. 

And they should take proper counseling and proper consultations from fetal medicine experts or the pediatric cardiologist who can help.

That’s all for today. Thank you for answering all your questions and I hope this will be very helpful for many of the viewers. Thank you.