You will learn if there’s something wrong with your baby’s heart at a fetal echocardiogram appointment. After the physician reviews the images, they will talk with you about the CHD diagnosis, how it can be treated, and the prognosis for the condition.

Note that if the physician doing the fetal echocardiogram is an obstetrician and they see something wrong with the heart, they may refer you to a pediatric cardiologist to confirm their findings. The pediatric cardiologist would do another fetal echocardiogram and give you more information about the treatment and prognosis.

Hearing that there’s a problem with your baby’s heart – whether mild or severe – can be overwhelming and traumatic. It is a common reaction to feel like you are in shock, or that your brain is shutting down or racing with fear.

When the physician tells you about the CHD diagnosis, you will receive a lot of information at a very difficult time for you. It’s okay to ask for time to process the news or compose yourself if you become emotional.

You can ask questions at any time during and after the appointment, so don’t worry if you can’t think of everything you want to know immediately. For many families, the most important thing to understand initially is what their child’s quality of life would be with CHD. Over time, you will get the information you need to plan for the future.

What Will I Learn From the Physician If They See a Problem?

  • What is abnormal about the fetal heart

    The physician may begin by telling you what a normal fetal heart looks like and how it works, and how the heart works differently after a baby is born. Then the physician will explain the problem they see in your baby’s heart. They may use diagrams to help.

  • How certain they are about the diagnosis

    The physician will tell you if they need more information before they fully understand the heart condition. Some parts of the heart may be difficult to see on the fetal echocardiogram because of the baby’s size or position, or because the heart structure is abnormal. If the physicians believe the heart may change or get more abnormal as the pregnancy progresses, the baby will have an echocardiogram after birth so they can see how the heart developed.

  • How to treat/manage the condition during pregnancy

    With many forms of CHD, nothing needs to be done for the fetal heart during pregnancy. However, there are some common follow-up steps to help manage the condition before birth. These can include genetic or other prenatal tests to monitor the baby’s health, follow-up fetal echocardiograms, more frequent checks by the obstetrician, maternal medications, and changes to the delivery plan.

  • What other medical professionals you should see

    The fetal cardiologist may suggest that you meet with additional care teams. This could include the neonatal intensive care unit (NICU) team at the hospital if your newborn will likely require their services. It might also include the heart surgeon if you want to learn more about the surgery they expect your baby will need.

  • How to treat/manage the condition after birth

    The fetal cardiologist will also explain what can be done for the heart after birth. This may include medications, heart surgery, or less invasive (non-surgical) procedures. They will explain the expected outcomes of possible procedures, as well as the prognosis for the heart condition and how it will impact your child’s life.

How Can I Manage All of This Information?

1. Take Your Time

Your physician knows that this news will change your life. They will understand if you need a break to process the information. It’s okay to cry or express whatever emotions you are feeling. You do not have to “hold it together.”

2. Start Asking Questions

Try to ask questions even if you feel uncomfortable or are not sure what to ask at first. It’s helpful for physicians to hear your questions. When they know what is important to you, they can prioritize talking about those issues.

3. Prepare to Follow Up

Make sure you know how to reach the fetal cardiologist’s office if you want to ask more questions later, after you’ve had time to think about the diagnosis and review the information. You can keep a list of your questions in a notebook or on your smartphone.

4. Expect to Feel Confused

After parents receive a CHD diagnosis, it’s common to leave the appointment with a lot more information – but feel even more confused. It may take time for your brain to process everything the physician tells you. Initially the information and medical terms may not make sense to you, and this can be very distressing when you are trying to understand what’s happening.

5. Keep Asking Questions

It’s important to clear up any confusion you may have once you get past the initial shock of the diagnosis. This is critical for your practical needs – like decision-making – and your emotional health. You can ask for a follow-up conversation with someone on the fetal cardiology team (physician, nurse, or social worker) by phone, videoconference, or in the office. Be sure to have your list of questions ready.

6. Write It Down

It will help to have a written record that you can add to over time, refer back to as needed, and share with others. The Mended Little Heart Guide includes worksheets you can complete with your pediatric cardiologist to make sure you have basic facts about your child’s CHD.

If There's a Problem With Your Child's Heart

It’s a whole new area of expertise that you never even thought you’d be a part of.

Ari, CHD Parent

PARENT TIPA CHD Diagnosis Affects You and Your Relationship With Your Unborn Baby

Early in the pregnancy you may or may not have a clear idea of your child. But as your baby continues to grow, you start to bond with him or her. You might see them on an ultrasound image and envision their personality or what their life will be like.

For many parents, a CHD diagnosis is a traumatic event that affects this bonding and causes strong reactions. It’s critical that you learn how to manage the uncertainty you will face and get the emotional support you need in your CHD care journey.

FAQs

Each appointment is different. It generally takes between 45 minutes and one hour to complete the fetal echocardiogram. Then the physician needs to review the images in detail before giving you the results. An obstetrician may wish to refer you to a pediatric cardiologist before giving you detailed information about the results. If the fetal echocardiogram is being reviewed by a fetal cardiologist, you should have the results about 15 minutes after they finish their review.

You may discuss the results in the room where the imaging is done, or you may be taken to a different room. If you are taken to a different room, use the break as an opportunity to take care of any personal needs you may have – like getting a drink of water or using the restroom.

Ask about what is important to you, and remember that you will have more opportunities to ask questions you think of later.

You might ask about your child’s expected quality of life – like their ability to go to school or play sports – and how often they would need to see a physician, undergo tests, or be hospitalized. You might also ask whether there is some uncertainty in the diagnosis, and whether they expect things to change during the pregnancy or after the baby is born.

For more ideas see:

If the fetal cardiologist identifies a significant heart condition, they may discuss terminating the pregnancy as a possible option, so that you are informed about all of your options. The physician typically does not advise you whether to terminate or not, since this is a very personal decision. Whatever you decide, your medical team should support you and any decision you make regarding the pregnancy.

Before making any decisions, you may want to get a second opinion from another specialist, or discuss the findings with a medical professional that you know and trust.

The fetal cardiologist will communicate the results of the fetal echocardiogram and their conversation with you to your obstetrician or maternal-fetal-medicine specialist, and provide them with a report. They will also assist in coordinating your follow-up visits.

Your physician may give you information about your child’s specific condition. In addition, you can explore online resources including:

  • American Heart Association
    This site has descriptions of many forms of CHD with diagrams. It also includes lists of resources for parents, informational materials, and the answers to frequently asked questions.
  • The Children’s Heart Foundation
    This site has brief descriptions and simple diagrams for common types of CHD. The organization publishes a free “It’s My Heart” book for parents, which has information about common types of CHD and treatment options.
  • Cove Point Foundation
    This site has information and diagrams about CHD, tests, and surgeries.
  • Heartpedia from Cincinnati Children’s Hospital
    On this site you can download a free application that has images and detailed descriptions of 12 types of CHD. Through the application you can view images of a normal heart compared to a heart with a defect. You can also watch videos with an audio description of different defects and how they can be surgically repaired.

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