Importance of Fetal Echocardiograms

There is a new report out concerning Fetal Echocardiography. Printed in two parts, it appears in the February 2010 and March 2010 issues of the newsletter Congenital Cardiology Today.

The first part of the report is mainly a synopsis of how a Fetal Echocardiogram should be done and who should do it. While a non-fetal echocardiographer will know how to obtain a four-chamber view of the fetal heart, the slightest hint of a problem should trigger a Fetal Echocardiogram. Detecting a heart problem, should one exist, depends on the time of the Fetal Echo (18-22 weeks is the best time) and the experience of the echocardiographer. And when a child has a heart problem diagnosed prenatally, their chance of survival increases 50%.

In the second part of the report (Fetal Echocardiography II: Congenital Heart Defects and Management; March 2010 issue of Congenital Cardiology Today, p. 3) the author contends “The prevalence of congenital heart malformations is higher than previously thought and is about 3-4 per 100 live births.” That’s quite the contention, and the author cites a 2008 study titled Prevalence of undiagnosed congenital cardiac defects in older children as proof. The authors of the 2008 study only used a pool of 143 children, which is pretty small. The smaller the study pool, the easier it is to obtain inaccurate results. Another study used a pool of 19,502 subjects and obtained results closer to the generally accepted ration: 8.8 children out of every 1000 are born with a Congenital Heart Defect. Both article abstracts are online; click the links and decide for yourself which study is more likely to be correct.

Despite my misgivings about the number of children born with a CHD, the report emphasizes the fact that when a standard sonogram raises doubts about the heart of the fetus, a Fetal Echocardiogram is highly recommended.

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4 Responses to “Importance of Fetal Echocardiograms”

  1. Cindy Castillo Says:

    Hi! Thanks for this entry! I can’t tell you how strongly I feel about this, but unfortunately it is difficult to convince people of this. I also advocate for third trimester ultrasounds but have as yet not been able to convince anyone I know to request one.
    I was living in Mexico when I got pregnant and was 5 months pregnant when my husband, our 3 year old and I decided to move to Canada where I am from. In Mexico they do an ultrasound every time you go to the ob/gyn so by that time I had had 5 or 6 ultrasounds and nothing out of the ordinary was detected. By the time we got settled and I found a doctor I was 7 months along. The doctor said she would do an ultrasound just because I hadn’t had one in Canada. I thank God for that decision every day. At that ultrasound they saw that our baby girl had critical aortic stenosis. When I went into labour I was airlifted to Edmonton, Alberta where they do pediatric heart surgery for all of Western Canada. When Alexa was being born her heart went from 90 bpm to 200 and then back down again. When she finally came out she couldn’t breath and had to be immediatly intubated. They tried for one month to save her left side but couldn’t and she had to be treated as if she had HLHS. She has had the Norwood and the Glenn and will have the Fontan in the next 6 months.
    So what if I hadn’t had the ultrasound at 7 months? What if they would have assumed everything was fine? Alexa would have been born in a city that wasn’t set up to do pediatric heart procedures. There wouldn’t have been a whole team there ready to intubate. Would they have been able to intubate her in time? Would she have been brain damaged from lack of oxygen? I’m very happy and thankful that I don’t have to know the answers to those questions.
    I just wish at least third trimester ultrasounds were offered. I think there would be a little less hardship.
    So thanks again for this entry!

  2. Janice Ladden Says:

    Almost the same thing happened to my old friend. When we moved to Texas, she went to see a doctor, and I’m glad the Dallas physical therapy team has the echocardiogram service.

  3. Stephanie Says:

    I had 6 ultrasounds done at Florida Hospital South, While I was pregnant. the last two because I was over 40 weeks and did not want to be induced.
    I thought everything was fine infill I gave birth. My son was born with TGA.
    Transposition of the Great Artery. The team their was good, he was on his way to children’s hospital in Tampa with in 2 hours of being born> I just Wish I had know before hand and could of gave birth over their.
    I would of know if I had a Fetal Echocardiograms. Needless to say he is 10 months and doing great even started to walk.

  4. What kind of heart diseases can an echo cardiogram detect? Says:

    […] Importance of Fetal Echocardiograms […]

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