image of pregnant woman getting an ultrasound

Fetal Echocardiogram: Cardiologists Evaluating Tiny Hearts

A fetal echocardiogram is a test done during pregnancy to evaluate the heart of an unborn baby. An echocardiogram can assess the function and structures of the heart. The test can help detect abnormalities of the heart before birth.

This information allows for earlier detection and for faster medical or surgical intervention, if necessary. A fetal echocardiogram is typically done in the second trimester, between 18 and 24 weeks.

How does a fetal echocardiogram work?

A fetal echocardiogram is an ultrasound test. The test uses soundwaves  that “echo” off the structures of the unborn baby’s heart, to allow the doctors to see how the heart beats and if there are any abnormalities.

When is a fetal echocardiogram necessary?

If screening tests with your regular obstetrician detect possible abnormalities in the baby, then a fetal echocardiogram may be done. Other cases where a fetal echocardiogram may be recommended include:

  • A family history of congenital heart defects (present from birth).
  • A previous child in the family born with a heart condition
  • Mother who has taken medications that can cause heart defects
  • Mother with other medical conditions that can affect the baby’s development, such as diabetes, or lupus

Who performs the test?

An experienced  sonographer or  “ultrasound technician” will perform the test by obtaining the images. A pediatric cardiologist will then review the images and talk with you about the results, usually on the same day.

What happens during the test?

Similar to an ultrasound, you will be asked to lie down and expose your abdomen . A special lubricating gel  is applied to the skin by the sonographer. The gel  helps to transmit soundwaves  and also prevents friction between your skin and the ultrasound transducer (the device that sends and receives the soundwaves). The soundwaves  are then reflected to build the images on a computer screen. You are able to watch the baby’s heart beat during the exam. The transducer is moved all over your abdomen to get many different angles of the baby’s heart. To look at all of the important parts of your baby’s heart development, the test usually takes an hour to perform and up to an hour to review the results. Total time expected for the visit should be about 2 hours.

What happens next?

If a heart defect is found, the cardiologist will work closely with the OB/GYN to monitor the health of both mother and baby. Our hospital has a dedicated team to support patients and families through the pregnancy, and after the birth, for all babies diagnosed with a possible heart problem.

Watch Knox’s story to hear about one family’s journey with congenital heart disease and for more information about the Heart Center at Nationwide Children’s Hospital, click here or follow #NCHheart on Twitter.



John Kovalchin, MD
John P. Kovalchin, MD, is Director of Echocardiography at The Heart Center at Nationwide Children's Hospital. Professor of Pediatrics at The Ohio State University College of Medicine. Dr. Kovalchin received his medical degree from the Northeastern Ohio Universities College of Medicine. He completed his residency at Nationwide Children's Hospital and fellowships at Texas Children's Hospital and the University of California Medical Center Parnassus. He is certified in both Pediatric Cardiology and Pediatrics.

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