గర్భధారణ స్కాన్లు
Fetal Echocardiography (Fetal Heart Scan)
Detailed ultrasound of your baby's heart structure
ఇది ఏ స్కాన్?
Fetal echocardiography (fetal echo) is a targeted, detailed ultrasound examination of your baby's heart. Unlike the routine four-chamber heart view on the anomaly scan, fetal echo is an in-depth assessment performed by a fetal medicine specialist or a paediatric cardiologist. It evaluates all four chambers of the heart, the valves (mitral, tricuspid, aortic, pulmonary), the great vessels and their connections (aorta and pulmonary artery — transposition, coarctation), ventricular septal and atrial septal defects, and the cardiac rhythm. It is done at 18–24 weeks, ideally around 22 weeks.
ఇది ఎందుకు చేస్తారు?
Congenital heart disease (CHD) is the most common major birth defect, occurring in approximately 8 per 1000 live births. Most cases occur in pregnancies with no known risk factor — but fetal echo is specifically recommended when risk is elevated. Indications include: family history of congenital heart disease (in a parent or previous sibling); maternal diabetes (GDM or pre-existing Type 1 or Type 2); maternal infection during first trimester (rubella, CMV); certain medications taken during pregnancy (lithium, some anti-epileptic drugs, SSRIs); increased nuchal translucency (NT ≥ 3.0mm) on the first trimester scan; chromosomal abnormality suspected or confirmed (Down syndrome has 40–50% CHD rate); and when the anomaly scan shows a possible cardiac finding that needs further evaluation.
ఏమి జరుగుతుంది
Fetal echo is usually performed transabdominally, though a transvaginal approach may be used early in the second trimester. The examination takes 45–60 minutes — significantly longer than a routine scan because the heart is examined from multiple angles and each structure is systematically assessed. It is performed by a fetal medicine specialist (perinatologist) or a paediatric cardiologist with fetal echo training. Some centres require a referral. No fasting or special preparation is needed, though some centres prefer you eat a light meal beforehand.
సాధారణ ఫలితాలు
- ✓ Four-chamber view normal: left and right ventricles equal in size, atria normal
- ✓ Mitral and tricuspid valves opening normally
- ✓ Aorta arising from the left ventricle; pulmonary artery from the right ventricle (normal connections)
- ✓ Interventricular septum and interatrial septum intact (foramen ovale is normal in fetal life)
- ✓ Aortic arch and ductal arch visible with normal flow
- ✓ Regular cardiac rhythm: 120–160 bpm
- ✓ No structural defects identified
ఎప్పుడు ఆందోళన చెందాలి
- Ventricular Septal Defect (VSD) — hole between the two lower chambers; most common CHD
- Transposition of the Great Arteries (TGA) — aorta and pulmonary artery switched; requires surgery after birth
- Hypoplastic Left Heart Syndrome (HLHS) — left side of heart severely underdeveloped
- Atrioventricular Septal Defect (AVSD) — common in Down syndrome
- Tetralogy of Fallot — combination of four cardiac abnormalities
- Fetal arrhythmia — sustained irregular heartbeat; may need fetal treatment
- Coarctation of the aorta — narrowing of the main artery
తరచుగా అడిగే ప్రశ్నలు
What is the difference between the heart check on the anomaly scan and a fetal echo?
The anomaly scan includes a basic cardiac screening assessment: the four-chamber view and ideally the outflow tracts. It takes 2–5 minutes as part of the full structural survey. Fetal echocardiography is a dedicated 45–60 minute examination of the heart alone, using higher resolution views, colour Doppler, spectral Doppler, and M-mode assessment. Fetal echo detects significantly more cardiac anomalies than the basic anomaly scan screening.
Who performs the fetal echocardiogram?
Fetal echo should be performed by a fetal medicine specialist (MFM/perinatologist) or a paediatric cardiologist trained in fetal cardiac imaging. It is not a routine scan that all sonographers perform. In India, most major cities have fetal medicine centres where this is available. You will need a referral from your obstetrician.
If fetal echo shows a heart defect, what happens next?
The fetal medicine specialist will counsel you about the specific defect — what it means, the severity, and whether it requires intervention after birth. Many CHDs are manageable with cardiac surgery in the newborn period. You will be referred to a paediatric cardiac surgeon for pre-birth counselling and your delivery will be planned at a hospital with a neonatal cardiac unit. Early diagnosis means the baby's team is prepared and the right treatment begins immediately.
I have gestational diabetes. Do I need a fetal echo?
Maternal diabetes — including GDM diagnosed in the first trimester, as well as pre-existing Type 1 or Type 2 diabetes — is an indication for fetal echo because it increases the risk of congenital heart disease. GDM diagnosed after 24 weeks (classic second trimester GDM) carries lower risk, but your obstetrician will advise based on when your GDM was diagnosed and how well controlled it has been.
How long does a fetal echo take and is it uncomfortable?
Fetal echo typically takes 45–60 minutes, sometimes longer if the baby is not cooperating. It is performed exactly like a regular abdominal ultrasound — gel on the belly, no pain or discomfort. The wait for the baby to be in a good position is the most time-consuming part. There is no radiation and no risk to you or your baby.