Fetal Cardiology

When you’re pregnant, you want the best for your unborn baby. We know a high-risk pregnancy or unexpected diagnosis can be scary. At CHOC Children’s, we deal with the unexpected every day, and have helped many families plan for their baby’s birth and medical care.

If your baby is at risk of having congenital heart disease (CHD), a CHOC board-certified pediatric cardiologist will perform an echocardiogram. If a heart defect is detected, we will counsel you on what to expect, prenatal interventions you may need, delivering your baby safely and the medical treatment they will receive afterward. Our goal is to answer all of your questions and provide you and your family peace of mind.

Video: When to Have Your Unborn Child's Heart Evaluated

Pediatric cardiologist, Dr. Nita Doshi, explains when and how to have your unborn baby’s heart evaluated in a high-risk pregnancy, or for a suspected abnormality.

Who Should Have a Fetal Echocardiogram

Fetal echocardiograms are not needed for all pregnancies. If your baby’s heart was evaluated during a detailed, second-trimester ultrasound, sometimes referred to as an anatomical survey, you may not require further testing with a fetal echocardiogram.

Pregnancies may be at risk for congenital heart disease for a variety of reasons. If you are pregnant with a child who is at risk for a congenital heart defect, you may be referred to CHOC by your OB/Gyn, perinatologist or health care provider for a fetal echocardiogram by a board-certified pediatric cardiologist.

We also welcome pregnant women who would like to schedule directly with us for a screening echocardiogram, additional consultation or second opinion.

You may see a CHOC fetal cardiologist for a number of reasons, including:

Fetal risk factors include:

  • During your second-trimester ultrasound, there was a suspected abnormality of the heart
  • Abnormal heart rate or arrhythmia on routine screening ultrasound
  • A suspected genetic abnormality
  • If there is an abnormality in another organ, such as the brain or kidneys, there may be an increased risk of associated heart disease
  • Identical twins
  • A two-vessel umbilical cord or abnormality with the placenta
  • Fluid accumulation in the baby

Maternal risk factors include:

  • Maternal diabetes mellitus prior to conception, during  first-trimester or uncontrolled diabetes mellitus
  • Assisted reproductive technology (IVF)
  • Metabolic disease
  • Autoimmune disease (Sjorgren’s syndrome or Lupus)
  • Medication or drug exposures
  • Maternal infections

Familial risk factors include:

  • Congenital heart disease in the mother, father or sibling

What To Expect At Your Appointment

Pregnant woman receiving a fetal echoCHOC board-certified pediatric cardiologists perform fetal echocardiograms in their offices to help detect heart abnormalities before birth. At the time of your appointment, your fetal cardiologist will deliver a comprehensive diagnosis and care plan for you and your family.

Treating heart conditions can be complex and often requires a team of caregivers. At CHOC, our cardiologists understand the specialized expertise and multidiscplinary approach needed to care for congenital heart disorders.

Depending on your child’s condition, you will be referred to other experts at the CHOC Heart Institute, such as cardiac interventionalists, cardiac electrophysiologists, cardiac surgeons and heart failure specialists as needed. Early intervention improves the chance of survival after delivery for babies with severe defects.

The CHOC Difference

  • CHOC offers the only comprehensive fetal cardiology services in Orange County
  • Board-certified pediatric cardiologists perform the fetal echocardiograms in their offices using state-of-the-art ultrasound technology
  • Comprehensive diagnosis and care plan for you and your family at the time of your echocardiogram
  • Same-day and next-day appointments offered for urgent fetal cardiology consultations
  • Dedicated fetal cardiology coordinator for patient and referring provider access, patient support and organization of all community resources
  • Maintain continued care your primary obstetrician or perinatologist and delivery center, when appropriate
  • Our fetal cardiology team coordinates with the chosen mother-baby unit and NICU teams in anticipation of deliveries with specialized needs
  • Our fetal cardiology team has advanced training in fetal cardiology and fetal echocardiograms
  • The CHOC fetal cardiology program is the only lab in the county with fetal accreditation through the Intersocietal Accreditation Commission (IAC), ensuring an advanced level of expertise

Frequently Asked Questions

What is a fetal echocardiogram (fetal echo)?

A fetal echocardiogram is an ultrasound performed to evaluate your baby's heart before birth. During this evaluation, your fetal cardiologist will check all of the baby's important heart structures, including their valves, pumping chambers, walls, veins and arteries of the heart, the baby's heart rate and rhythm, and the overall heart function. Learn more about fetal echocardiograms.

What is the ideal timing to perform a fetal echocardiogram?

A fetal echocardiogram should generally be performed at 18-22 weeks pregnant, the time at which most second trimester ultrasounds are performed to screen for other abnormalities.

Is a fetal echocardiogram harmful to my baby?

A small camera called a transducer is placed on your abdomen and will send out ultrasonic sound waves to the baby's heart where waves bounce or "echo" off the heart structures. The transducer picks up these reflected waves and sends them to a computer that combines the "echoes" into an image of the heart. Ultrasound is a non-radiation-based imaging modality. There are no documented reports of fetal injury during the recommended time frame to have a fetal echocardiogram.

Why am I being referred for a fetal echocardiogram?

Fetal echocardiograms are not indicated for all pregnancies. If your baby's heart was evaluated during a detailed second-trimester ultrasound, sometimes referred to as an anatomical survey, you may not require further testing with a fetal echocardiogram. If you, your baby or your family have high-risk factors for your unborn baby to have a congenital heart disease (CHD), you will be referred for a fetal echocardiogram. Learn more about high-risk factors for your unborn baby.

What are the goals of performing a fetal echocardiogram?

While a fetal echocardiogram may detect minor congenital heart conditions (such as very small holes in the heart walls), the main goal is to evaluate for a significant heart condition that may affect the safety of the baby and mother prenatally, at the time of delivery, or immediately after birth. If one of these conditions is identified, prenatal monitoring and delivery planning is very important to the heart health of the baby and the mother.

What are the chances my baby will be diagnosed with congenital heart disease?

Congenital heart disease is the most common birth defect. It is estimated that 1 in 100 babies are born with congenital heart disease. Approximately 1 out of 4 of these babies are estimated to have congenital heart disease (CHD) that will require heart surgery during infancy.

What are examples of congenital heart disease that may be detected in utero?

The most common types of congenital heart defects that are diagnosed in utero may include:
  • Aortic and pulmonary valve stenosis
  • Ventricular septal defects
  • Atrioventricular canal defects
  • Cardiac masses and tumors
  • Cardiomyopathy (enlarged or thickened heart)
  • Coarctation of the aorta
  • Double outlet right ventricle
  • Fetal arrhythmias
  • Hypoplastic left heart syndrome
  • Pulmonary atresia
  • Single ventricle type complex congenital heart disease
  • Tetralogy of Fallot

What makes the CHOC Children's fetal cardiology program unique?

The CHOC fetal cardiology team is made up of a highly specialized team of board-certified pediatric cardiologists with specialized expertise in fetal echocardiography and fetal cardiology evaluation and treatment. Our team also includes accredited fetal cardiac sonographers and a fetal cardiac nurse coordinator. We are proud to offer comprehensive family-based fetal cardiac diagnosis and treatment services.

To schedule a consultation please call (714) 509-3960. Or to request more information, fill out the form below and one of our fetal cardiology care coordinators will reach out.