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What is a fetal echo?

Foetal echo, also referred to as a foetal echocardiogram, is a test that uses ultrasound waves to obtain a detailed image of the heart of an unborn baby. It is generally done in the second trimester of pregnancy, i.e., in 18 to 24 months of pregnancy, primarily for identifying heart conditions in the developing foetus.

  1. Why is a fetal echo performed?
  2. How do you prepare for fetal echo?
  3. How is a fetal echo performed?
  4. What do fetal echo results mean?
  5. How much does a Fetal echo cost?

A routine ultrasound cannot obtain an image of the unborn baby’s heart; however, a foetal echocardiogram helps in diagnosing defects in walls or valves of heart in an unborn baby. It can also help find defects in blood vessels that supply blood to the heart and carry blood away from the heart to various parts of body. This test also identifies the blood pumping strength of heart and is recommended in the following conditions:

  • A family history of heart defects, e.g., a sibling, parent or any close relative of the baby has a heart defect (Read more: Congenital heart disease symptoms)
  • Abnormal results obtained on a routine ultrasound test during pregnancy, e.g., abnormal heart rhythm
  • A genetic disorder identified in a developing baby
  • If the pregnant woman had phenylketonuria, diabetes or lupus before the conception of the child
  • If the pregnant woman had rubella in the initial stages of pregnancy

No special preparation is needed for a fetal echo test, and the pregnant woman is allowed to eat or drink any food of her choice before the test. However, it is recommended to avoid applying a cream, lotion or any other product on the belly area. It is not necessary for the bladder to be full before the test.

This test is performed by a paediatric cardiologist. The procedure is similar to that of a pregnancy ultrasound. (Read more: 3D ultrasound during pregnancy)

The pregnant woman is asked to lie down, clear jelly is applied to her abdomen and a probe is moved around over the abdomen to obtain images from different locations until a clear structure of baby's heart is obtained. The following techniques are employed to get a detailed structure of the heart:

  • Two-dimensional echocardiography: This procedure shows the actual structure with real-time motion of various structures of heart, which can then be evaluated by the doctor.
  • Doppler echocardiography: It aids in detecting the speed of blood flow in heart and thereby any issues associated with heart valves, which connect the four chambers of the heart. Colour Doppler is another technique used to determine the direction of blood flow in heart.

Ultrasound waves used for the test are not felt on the skin, but the conducting gel causes a slightly wet and cold feeling. This test does not pose any risk to the mother or the unborn baby.

It may take 30 minutes to 2 hours to obtain clear images of baby's heart. In some instances where the position of the baby makes it difficult to capture clear pictures, it may take longer.

Results of a fetal echo are obtained on the same day in most cases. A doctor will interpret the results and identify the presence or absence of any problem.

Normal results:

Absence of any abnormalities in the foetal heart is considered to be a normal result.

Abnormal results:

Any defects identified in foetal heart may be due to disturbances in rhythm, working or structure of the heart. The test may be repeated to confirm the diagnosis.

Although this test is useful in detecting abnormalities in the heart of the unborn baby, it is not efficient enough to identify all the problems. This is because some issues, such as a hole in the heart, cannot be diagnosed before birth.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor. 

The cost of foetal echo can vary in the range of 1,620 to 3,500 INR in India. However, it may vary from city to city and between laboratories.

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  1. Hagen-Ansert SL, Guthrie J. Fetal echocardiography: congenital heart disease. In: Hagen-Ansert SL, ed. Textbook of Diagnostic Sonography. 8th ed. St Louis, MO: Elsevier; 2018:chap 36.
  2. Donofrio MT, Moon-Grady AJ, Hornberger LK, et al. Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation. 2014;129(21):2183-2242. PMID: 24763516
  3. Stamm ER, Drose JA. The fetal heart. In: Rumack CM, Levine D, eds. Diagnostic Ultrasound. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 37.
  4. Stanford Children's Health: Lucile Packard Children's Hospital, Stanford; Fetal Echocardiography
  5. Nitin G. Chaubal and Jyoti Chaubal. Fetal echocardiography. Indian J Radiol Imaging. 2009 Feb; 19(1): 60–68. doi: 10.4103/0971-3026.44524. PMID: 19774143
  6. ©2018 The Children’s Hospital of Philadelphia; Fetal Echocardiogram
  7. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Fetal Echocardiography
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