When is a Fetal Echocardiogram Advised?

Being referred for a fetal echocardiogram (fetal echo) is a common step during pregnancy. It does not mean a problem has been found — in most cases, it is simply a precautionary check to ensure your baby's heart is developing normally.

A fetal echo is safe, non-invasive, and performed exactly like a regular pregnancy ultrasound. It is a detailed look at the structure, function, and rhythm of the baby's heart.

Common Reasons for Referral

Referrals are typically guided by specific maternal health conditions, findings on a routine pregnancy scan, or family history. Below are the primary reasons your care team might recommend a scan:

• Maternal Health Factors:

  Certain maternal health conditions can affect fetal heart development. These include diabetes diagnosed before pregnancy, autoimmune antibodies (such as anti-Ro or anti-La), a known maternal heart condition, early pregnancy infections (like rubella), or if the pregnancy was conceived through IVF or ICSI.

• Findings on a Routine Scan:

  If a routine anomaly scan or growth scan shows an unusual cardiac view, an irregular heart rhythm, fluid build-up (hydrops), growth restriction, or increased nuchal translucency (neck thickness) at the 11–13 week scan, a specialist fetal echo will be advised to get a clearer picture.

• Family History & Genetics:

  A scan is recommended if a parent or previous child has a congenital heart defect, or if there is a known genetic or chromosomal finding (such as Down syndrome) identified in the current pregnancy.

• Assessing Heart Performance (Functional Studies):

  Sometimes, the scan is done to measure the heart's pumping strength, evaluate blood flow through key vessels (using Doppler studies), or monitor the heart's response to medical therapy or transfusions.

• Reassurance:

  For parents who have experienced a previous stressful pregnancy or have high anxiety, a fetal echo can be performed purely for reassurance, to confirm that the baby's heart is developing healthy.

When is the scan usually done?

The optimal window for a detailed fetal echo is between 18 and 22 weeks of pregnancy. In higher-risk cases, an early scan can be performed around 14–16 weeks (sometimes starting transvaginally at 11–13 weeks) and is always followed by a confirmatory scan during the standard 18–22 week window.