The incidence of having a baby with heart disease is about 8-10/1000 live births in India. This means out of 1000 live births, 8-10 are babies who are born with heart problems that could have been detected antenatally. These can lead to lifelong disability and even death.
Hence, detection of critical heart defects in the antenatal period is important.
The purpose of fetal echocardiography is to do a detailed assessment of the fetal heart, its connections and the blood flows by means of ultrasound.
What people have to understand is that many do not assess the fetal heart in detail. They just restrict to the evaluation of one view only, that is, the 4-chamber view. if the evaluation is just restricted to 4 chamber view, then we can miss 40% of major congenital heart defects.
How is the assessment by a fetal medicine specialist different?
We as fetal medicine specialists assess the heart in detail. Minimum evaluation of the heart requires an assessment of 4 chamber views, outflow tracts, and 3 vessel views. But we do not restrict ourselves to this, we do a detailed assessment for every fetal heart at the time of anomaly scan. We also try to look at the anatomy of the fetal heart every time we scan to rule out evolving lesions.
Hence, every scan does not require fetal echocardiography.
When is fetal echocardiography required?
Fetal echocardiography is required in –
1. If a detailed assessment of the heart is not done at the time of the anomaly scan.
2. If the mother or sibling or family have a history of congenital heart disease, then there is a minute risk of recurrence, hence a detailed fetal heart is advised.
3. If the mother has a history of medical disorders like Diabetes Mellitus, connective tissue disorders- SLE, Sjogren’s syndrome
4. If there is suspicion of structural or rhythm abnormality in the fetal heart
5. If there is the detection of increased nuchal translucency or any other abnormality in the baby, a detailed fetal echocardiographic evaluation is advised.
6. If the mother is obese or there are suboptimal views, then fetal echocardiography may be advised.
You can consult with Dr.Neha Gupta the fetal medicine consultant.
