A fetal echocardiogram (fetal echo) is a specialized ultrasound that creates detailed pictures of your baby’s heart while they are still in the womb. This safe, non-invasive test focuses specifically on the structure, function, and rhythm of the developing heart. It is frequently recommended for pregnancies conceived through assisted reproductive technology (ART), such as In Vitro Fertilization (IVF), as a precautionary part of prenatal monitoring. This detailed assessment helps medical teams prepare for the baby’s care before birth.
Why IVF Pregnancies Require This Scan
The primary reason for recommending a fetal echocardiogram is the slightly increased statistical association between IVF conception and congenital heart defects (CHDs). While the chance of having a baby with a CHD in the general population is approximately less than 1%, studies suggest this risk may be nearly double for IVF-conceived pregnancies. This difference is often attributed to underlying parental infertility issues, the medications used during treatment, or the IVF process itself, though the exact cause remains unclear.
The scan is a screening tool, not an indication that a problem definitely exists. The vast majority of IVF pregnancies result in perfectly healthy hearts. The test provides a comprehensive assessment that goes beyond the view obtained during a routine anatomy scan. Some newer data suggest that if the heart looks entirely normal on a detailed routine ultrasound, the incremental benefit of a screening fetal echo may be limited, but the procedure remains common practice for the highest level of prenatal surveillance.
Preparing for the Fetal Echocardiogram
The fetal echocardiogram is typically scheduled during the second trimester, most often between 18 and 24 weeks of gestation. This timing allows the baby’s heart structures to be large enough for a detailed evaluation. The procedure is performed by a specialized sonographer and the images are then interpreted by a pediatric cardiologist.
Unlike some other prenatal ultrasounds, you do not need to have a full bladder for this exam, and you can eat and drink normally beforehand. Avoid applying lotions or creams to your abdomen on the day of the test, as these can interfere with the ultrasound gel and image clarity. Because the procedure is highly detailed, the appointment can last anywhere from 30 minutes to up to two hours, depending on the baby’s position and cooperation.
The Examination Procedure
The procedure itself is very similar to a standard prenatal ultrasound, using high-frequency sound waves to capture images. You will lie on an examination table, and a clear, water-based gel will be applied to your abdomen before the sonographer gently presses a transducer wand against your skin.
The fetal echo involves a focused and extensive review of the cardiac anatomy, unlike a typical anatomy scan that briefly checks the heart. The sonographer captures multiple precise views of the four chambers, the valves, and the major blood vessels entering and leaving the heart. Doppler technology is also used, which appears as color on the screen, to track the speed and direction of blood flow. You may be asked to shift position a few times to help the sonographer get the clearest views.
Understanding the Results and Next Steps
In most cases, the pediatric cardiologist will review the images and provide preliminary results on the same day as the exam. A normal result confirms that the heart’s structure and function are developing as expected, and you will continue with routine prenatal care. Even a normal scan cannot detect every heart issue, as some minor problems, like very small holes, may not become apparent until after birth.
If the scan reveals an atypical finding or a confirmed congenital heart defect, you will be referred for consultation with the fetal cardiology specialist. This consultation will explain the diagnosis, discuss the likely course of action, and determine if further testing, such as a fetal MRI or genetic testing, is warranted. For more serious diagnoses, a plan will be created for the remainder of the pregnancy and delivery, which may involve delivering the baby at a hospital with a specialized Neonatal Intensive Care Unit (NICU) and pediatric cardiac services. Early diagnosis allows the medical team to prepare for any necessary intervention immediately following birth, which can significantly improve outcomes.