14 – 23 weeks
The echo of tiny heart-beats
Your baby’s heart is special. There may be times when special care is needed to look in detail for potential life-threatening problems. The routine anatomy scan will detect only 60% of heart problems. If you need more reassurance or have learned your baby is at risk, then our cardiac consultants will be there to support and reassure you.
Fetal echo is often referred to as fetal echocardiography and is an advanced and comprehensive ultrasound scan of your baby’s heart whilst in the womb.
The scan looks for congenital heart defects (CHD), problems affecting around 8-10 per 1000 live births. Congenital means that the problem is present at birth and has happened during baby’s time in the womb. Major problems with the heart account for 25% of all birth defects and are the most common cause of death in childhood due to conditions going undetected before birth.
The presence of a problem with baby’s heart can be an indicator of other structural or chromosomal abnormalities.
Routine ultrasound scans of your baby’s heart at 20 weeks may only pick up around 60% of defects depending on the skill of the operator and the protocol that is followed.
This detailed specialised scan however is tailored to your needs and the timing of the scan will depend on the reason why the scan is requested. For example, if you received an increased thickened nuchal measurement, your baby is at risk of having a heart problem and you may wish to have the cardiac or heart scan at an earlier date to reduce the wait until 23 weeks.
Indications for fetal echo
Someone in the family was born with a heart defect. In the NHS, fetal echo is offered if you, the baby’s father or a previous child has had a heart problem or required surgery for a heart condition.
Having diabetes can increase the risk of a heart problem in baby. In the NHS, Fetal Echo Scans are offered only if pre-existing diabetes was poorly controlled at the time of conception.
Problems found on scan
An increased Nuchal Translucency (NT) has a high-risk of 1 in 30 of a possible heart defect. Also, a suspected problem may be identified during your routine 18 – 20 week scan.
Twin / multiple pregnancies are normally categorised as high-risk as are all IVF pregnancies. You may not be offered a detailed fetal heart scan on the NHS in these circumstances.
The fetal echo scan
Usually the scan is performed between 18 and 22 weeks but can be done as early as 14 weeks. The heart is a complicated organ to see and understand that it can take up to 30 minutes depending upon how the baby is lying in the womb to complete the test.
A detailed assessment of the heart will check:
- Major structural abnormalities of the heart where chambers or vessels have not formed properly
- Major structural abnormalities of the heart where chambers or vessels are not connected properly
- Significant holes in the heart
- Significant abnormalities of the heart valves
The heart scan also uses ultrasound techniques including pulse wave and colour flow Doppler techniques. This allows us to see:
- How the blood is flowing through your baby’s heart chambers
- The arteries and veins which carry blood towards and away from the heart to the body
- The speed of blood flow to detect any narrowing of the arteries
- If any valve problems are present such as not opening or shutting normally
Fetal echo scan results
Our Fetal Cardiologist is a specialist dedicated to looking at the heart and will reassure you and advise you immediately on what the scan shows.
It is reassuring to know that in most cases, the baby’s heart will be normal. Minor problems such as a small hole in the heart will usually repair themselves and is unlikely to require any medical interventional treatment.
This scan will detect up to 75% of all heart defects, that being said, we are often able to pick up major heart problems in over 60% of cases at 14 weeks, 85% at 18 weeks and 90%+ at 23 weeks.
You will receive full support and expert counselling and advice should any problem be detected. We understand how traumatic such news can be but in many cases intervention can be very successful and you will be informed of all procedures that are available to you if and when needed. Your follow up care will also be arranged for you, and you will feel more in control and able to cope with as a result of having this very specialised consultation and care.