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Could Your Unborn Baby Have a Heart Defect?

The facts about congenital heart disease

Cardio heart iconCongenital heart disease (CHD) is the most common birth defect

Cardio heart iconApproximately 1 in 100 babies are born with CHD

Cardio heart icon1 of 4 of these babies are estimated to have CHD that will require surgery during infancy

Knowing if you’re at risk can help you prepare
for your baby’s birth.

 

Catching a Heart Defect In Utero: Marco's Story

“At my 19-week ultrasound, I was informed that the ultrasound technician was not able to measure an area of Marco’s heart because of placement and not to worry as all the other structures looked normal,” says Marco’s mom, Meagan.

When a second ultrasound by a perinatologist confirmed that baby Marco’s aorta was enlarged, Megan was referred to CHOC Fetal Cardiology specialists. The evaluation confirmed Marco had Tetralogy of Fallot, and that he would need heart surgery to live. Meagan was able to prepare for Marco’s birth and he is a happy, thriving baby.

Smiling baby Marcos

What You Need to Know About Your Second Trimester Ultrasound

When you are pregnant, your medical practitioner will order a detailed ultrasound (sonogram) typically at 20 weeks, but they can be done anytime between 18 weeks and 22 weeks. The second-trimester ultrasound is a comprehensive anatomy assessment to be sure everything is growing and developing as it should with your baby.

Your baby’s heart will be looked at to detect potential heart defects during this ultrasound. To ensure heart defects are seen at your second-trimester ultrasound, it’s important that:

  • You receive a high-quality screening
  • Ask the person performing the ultrasound if they have a clear visualization of all four heart chambers and the great arteries, also referred to as the outflow tracts

Heart defects can be missed without a clear look at all of these structures.

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

Risk Factors for Congenital Heart Disease

Pregnancies may be at risk for congenital heart disease for a variety of reasons. If you, your baby or your family have high-risk factors for your unborn baby to have a CHD, your healthcare provider may refer you for a fetal echocardiogram by a board-certified pediatric cardiologist. 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
  • Congenital heart disease in the mother, father or sibling

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. At CHOC, our board-certified fetal cardiologists welcome referrals from healthcare providers, as well as direct appointments with pregnant women who would like to schedule directly with us for a screening echocardiogram, additional consultation or second opinion.

Frequently Asked Questions About Fetal Echocardiograms

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.
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.
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.
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.
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.
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.
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
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 or get more information, please call (714) 509-3960. Or fill out the form below and one of our fetal cardiology care coordinators will reach out.