FREQUENTLY
ASKED QUESTIONS ABOUT FETAL ECHOCARDIOGRAPHY
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Q:
Why am I having a fetal echocardiogram?
A: A fetal echocardiogram uses ultrasound, or high-frequency sound waves, to
look at the heart and major blood vessels of the fetus.
Q:
Why is this procedure necessary?
A: Most women undergo a fetal echocardiogram to look for congenital heart defects,
which are abnormalities of the heart that occur during development. Some women
are referred because of a heart rate abnormality detected during routine monitoring
of the pregnancy.
Your obstetrician
will refer you to a specialist with expertise in fetal heart
disease. A fetal echocardiogram may be performed routinely
beginning at 18-22 weeks gestation, but an earlier study
may occasionally be indicated. It is an extension of the
screening ultrasound examination that many pregnant women
have performed during the fourth or fifth month of pregnancy.
A fetal
echocardiogram is able to diagnose only serious structural
abnormalities of the heart. Minor heart defects, abnormalities
involving very small structures, and abnormalities in the
change from a fetal circulation to a newborn circulation
can only be detected after birth.
Q:
Is the procedure painful? What must I do to prepare for
it?
A: The examination is painless and does not harm the fetus in any way. No special
preparations are required. Like the screening ultrasound examination, the fetal
echocardiogram is performed with the transducer (the probe that is used to
take the pictures) on the women’s abdomen.
Ultrasound
sound images are slices of information obtained by aiming
the ultrasound from one end of the heart to the other. The
fetal heart is quite small, and the images are magnified
on the screen of the ultrasound machine. Color Doppler is
used to confirm normal flow patters seen in the circulation
of the baby.
An initial
fetal echocardiogram takes approximately 30 to 45 minutes
to perform. Because of technical limitations, some patients
may require a second examination.
Q:
What can I expect upon arrival for the examination?
A: The examination room will contain a bed to lie on, an ultrasound machine,
and transducers. In most cases, you may have a relative or friend present during
the fetal echocardiogram just like any other prenatal ultrasound. In order
to avoid distractions you should not bring young children into the examination
room.
The Sonographer
or doctor will apply ultrasound gel to a transducer. The
transducer is a wand-like device that sends and receives
the harmless ultrasound waves. The gel makes it possible
to conduct the procedure and obtain the images. Ultrasound
images are then taken of the baby’s heart from several angles,
requiring movement of the transducer over the abdomen and,
often, repositioning the patient on the bed.
The important
parts of the echocardiogram are recorded on videotape or
stored on a computer disk for later review and for record
keeping.
Q:
What will we see and hear on the echocardiography machine
during the exam?
A: Ultrasound waves used in performing the echocardiogram are not audible to
the human ear, so you will not hear the sound waves.
Structures
will be displayed in “real-time” and appear as white moving
objects on the screen. For example, the valves of the heart
will look like white flap-like moving structures. Areas of
the heart where there is fluid or blood look black on the
screen.
During the exam, you will notice the sonographer placing marks on the screen
with small computer calipers. The sonographer uses the calipers to perform
various measurements of the size, function and blood flow of the heart.
An echocardiogram
exam usually includes a Doppler recording of the blood movement
or flow within the heart. When color flow Doppler is used
in the exam it will appear as different colors moving within
the white and black images on the monitor. The different
colors represent the different speeds and directions of blood
flow in the heart.
Doppler
examinations often also include an audio signal of the blood
flow. These audio signals can be heard and seen. During the
audio Doppler recording, you will hear the sound of the blood
moving through the heart and the sound of the heart valves
opening and closing. The audio signals are also displayed
as a graph on the monitor. These graphic recordings help
the physician to determine valve function and heart pressures.
Q:
What happens after the fetal echocardiogram?
A: After the procedure, the ultrasound gel will be wiped off your abdomen.
The sonographer will, in general, not provide you with any results, so that
the doctor can properly review the videotape the images.
You will
often be counseled by a doctor to explain the preliminary
findings. Occasionally, it may be necessary to perform additional
measurements and assessments during the review of the study.
We will prepare a final report usually within a day. We appreciate
your patience as we complete our procedures.
