It is an ultrasound method that can be performed on the mother's abdominal skin, starting from the 16th week of pregnancy, while the baby's heart begins to beat in the 3rd week of pregnancy, while it is still in the mother's womb. It is also called "fetal echo" for short. It is an examination in which the ultrasound performed by the obstetrician during your follow-up is performed with special probes developed for the baby's heart, and the ideal time is between the 16th and 24th weeks, but it can also be performed throughout the entire pregnancy. Generally, a "fetal echo" procedure is performed once during the entire pregnancy. In some clinical situations, very close cardiac monitoring may be required; Fetal echo can be repeated once a month, every two weeks or even once a week. Today, 80-90% of the heart pathologies of the baby in the womb can be diagnosed with fetal echocardiography. Fetal echo, a special ultrasound method, does not cause any harm or side effects to you or your baby. It does not require a special condition such as hunger or satiety and can be applied at any time of the day. Ultrasound duration is approximately 20-30 minutes, although it depends on a number of factors such as the baby's position in the uterus, its position, whether it is active and mobile, the placement of the baby's partner (placenta), whether the mother is overweight or obese, and the structure of the abdominal wall. In some heart anomalies detected in the baby, this period can be up to 45 minutes.
Who should have fetal echocardiography?
In some cases recommended by the guidelines, it is strongly recommended to have a fetal echo. Situations that constitute indications are as follows:
1. Abnormalities suggestive of chromosomal disorder detected by your gynecologist in biochemical screening tests (double test, triple test, quadruple test) or ultrasound (increase in nuchal thickness, absence of nasal bone, missing a vein in the umbilical veins, kidneys, brain, arms or legs, other Presence of developmental anomalies detected in internal organs)
2. If the gynecologist suspects a heart pathology (perforations, anomaly in the vessels or their outlets, problems in the valves or chambers, abnormality in the heart cavities, the heart appearing large, the presence of fluid or mass around the heart, irregular rhythm)
3. A chromosomal anomaly detected in the baby by amniocentesis or NIPT (Down syndrome, Tri In the presence of (e.g., somia 13, trisomy 18)
4. In the presence of a history of recurrent miscarriage or stillbirth
5. Some drugs used by the mother just before or during pregnancy, alcohol or narcotic substance use, exposure to radiation
6. Advanced gestational age and advanced paternal age (>35 years), multiple pregnancies (twins, triplets)
7. In some flu cases and other infectious diseases experienced by the mother, especially in the early stages of pregnancy
8. Some diseases present in the mother (diabetes, blood pressure disease, thyroid disease, some systemic diseases and rheumatic conditions)
9. Presence of congenital heart disease in mother, father, siblings or first degree relative
10. Irregularity in the baby's heartbeat, heart beating lower or higher than normal, abnormality in NST
11. Fetal echo is recommended for the whole family, especially the mother and father, to eliminate concerns about the baby's heart health.
What should be done when a problem is detected in fetal echocardiography?
In most cases of heart anomalies detected in the womb. is expected until birth. The baby is monitored regularly throughout pregnancy depending on the anomaly, and the structural problem in the heart is evaluated with transthoracic echo after birth. In some heart diseases, surgical or interventional treatment is required for the baby immediately after birth, and these pregnant women are informed about having their birth in a tertiary center (pediatric heart physician, pediatric cardiac surgeon, neonatal physician). Some structural heart pathologies are quite severe and unfortunately, a full surgical or interventional treatment is not possible in this patient group, and heart transplantation is on the agenda. In some babies in this patient group, loss or stillbirth may occur in the later months of pregnancy. Babies with severe anomalies detected in fetal echo, along with other accompanying findings, should be discussed by gynecologists in a comprehensive council, and the option of elective pregnancy termination before the 24th week of pregnancy should be presented to the family and the family should be informed. In case of some rhythm disorders (situations such as heartbeat being too high or low, too irregular), fetal echo should be repeated at frequent intervals and the mother should be informed. If necessary, oral drug treatments should be started.
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