What Is a Fetal Echocardiogram?

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An echocardiogram, commonly called an “echo,” is a test that uses ultrasound, or high-frequency sound waves, to create images of the heart. The sound waves go through the skin and tissues and bounce off the structures (like the heart), and a wand picks up these reflected waves, sending pictures to the computer.

This test allows a health care provider to look at the structures of the heart as well as assess the functioning. During pregnancy, a fetal echocardiogram is done to look at the heart of the fetus, and can help determine whether there are any structural abnormalities or defects.

What Is It Used For?

Not every pregnant person receives a fetal echocardiogram. This test is only done when a routine ultrasound finds something that requires further exploration, or if certain risk factors are involved. These risk factors can include:

  • A previous sibling born with a congenital heart defect
  • Family history of congenital heart defects or problems
  • Diagnostic testing revealed a chromosomal or genetic abnormality
  • Alcohol or drug abuse by mother while pregnant
  • If the mother has certain conditions like lupus, PKU, diabetes, or connective tissue disease
  • If the mother has taken any medications that might cause heart problems in a fetus

If a fetal echocardiogram needs to be performed, this is typically done during the second trimester, between 18–24 weeks of pregnancy.

How Does It Work?

To do an echocardiogram, you’ll lay down on an exam table, just like a regular ultrasound. It is typically administered by a pediatric cardiologist or an assistant. They’ll put the gel on your belly that helps the sound waves travel from the ultrasound wand to make the picture.

This is not an invasive test, so everything is on the surface of your skin—no needles or pain, although you might feel some pressure from the wand being pressed on your belly. The test will take anywhere from 30 minutes to 2 hours, depending on how many pictures they need, the positioning of the fetus, and what it is they’re looking for.

There might be different kinds of ways the cardiologist will obtain images of the fetal heart, to get as much detail as possible:

  • 2-D (two-dimensional) ultrasound: This allows the doctor to see the structures and function of the heart, in real-time.
  • Doppler echocardiography: This is used to measure the speed of blood flow in the chambers and valves of the heart.

The doctor will generally have the results of the fetal echocardiogram within 1 or 2 days.

You don’t need to do anything special to prepare for a fetal echocardiogram, and unlike an ultrasound, you don’t need to have a full bladder. You can eat and drink as you normally would. You will be asked not to put any lotion, creams, or powders on your belly the day of the test.

Risks and Benefits

A fetal echocardiogram is a safe, non-invasive procedure that carries no risks to you or the fetus.

By finding any cardiac abnormalities or issues while in utero, it makes it possible to plan for any necessary medical or surgical treatments or interventions directly after birth, as well as any possible fetal surgery, if applicable.

Other Benefits

  • Additional tests or scans can be done to monitor the situation once they know what is present.
  • If necessary, amniocentesis can be performed to determine whether various genetic conditions or abnormalities are present.
  • Genetic counseling can be provided about any condition that was found, what it means, the genetic likelihood in the family, and how to manage it.
  • If abnormalities are found, it allows you to seek out support on how to care for a child with the condition, as well as plan for treatment after birth.

A Word From Verywell

Hearing that you need a fetal echocardiogram done can be scary, but the procedure itself is painless and over quickly. If your doctor suggests that a fetal echocardiogram should be done, talk with her about the indications for ordering it, what she might be looking for, and what you can expect with the test. Once you have the results, you’ll be able to prepare for what lies ahead and make decisions for the health of your baby.

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