When your obstetrician refers you for a fetal echocardiogram, you will see a physician with additional training in fetal echocardiography. This is generally either a maternal-fetal medicine specialist or a fetal cardiologist.

A fetal echocardiogram can identify most types of major congenital heart disease before birth.

It is normal for parents to feel worried when their physician recommends a specialized study of the fetal heart. If you don’t understand why you are having the test, ask the physician who is referring you. In many cases, there is only a small chance that the fetal echocardiogram will be abnormal.

Why Is a fetal echocardiogram Done?

There Is a Known Risk

Some pregnant women are referred for a fetal echocardiogram because there is a situation that increases the chance of a congenital heart defect in the baby. This includes women with diabetes and challenges controlling their glucose. It also includes parents who used in vitro fertilization or have a family history of congenital heart disease.

There Is a Need for More Information

In some cases, a fetal echocardiogram is done because it was difficult to see your baby’s heart on the routine obstetrical anatomy scan performed in the second trimester of most pregnancies.

There Is a Concern

In a routine scan, your physician may see something in the structure or rhythm of your baby’s heart that concerns them. There is a higher chance that the fetal echocardiogram will find an abnormality in the fetal heart when an obstetrician or maternal fetal medicine (MFM) specialist notices a possible problem on their images.

What to Expect in a fetal echocardiogram

  • 1. You go to the appointment

    A fetal echocardiogram may be done at an obstetrician’s office, a maternal-fetal provider’s office, a pediatric cardiologist’s outpatient office, a fetal program, or the heart center at a hospital. Your referring physician may make the appointment for you, or you may need to make the appointment yourself.

  • 2. You have the test

    Once you arrive and check in, the first step is for either a sonographer or a physician to perform the fetal echocardiogram. The test generally takes about 45 minutes to one hour, but it can take longer if the baby is in a challenging position or if there are abnormal findings.

  • 3. The physician talks with you

    Once the imaging is complete, the physician will review the images and then meet with you to discuss the results. If no abnormalities are found, additional tests after the baby is born may not be necessary.

  • 4. You learn if there’s a problem with your child’s heart

    If there are abnormalities, the physician will explain their findings. They will tell you what repair may be necessary after birth and the options for next steps. If the physician is a MFM, they may refer you to a pediatric cardiologist for more imaging and detailed counseling about the condition.


The ultrasound takes many short video clips of your baby’s heart and its related structures from different angles. This helps your physician examine and evaluate the blood flow patterns in these structures.

Yes. The fetal echocardiogram uses the same machines as a routine anatomy scan. While there are some extra precautions that the operators take in the first trimester scanning to reduce risk, in general this is a safe and widely used technology to image fetal anatomy prenatally. There is no radiation involved.

The fetal cardiologist (or other physician) who performed the test will provide a report of your visit and test results to your referring obstetrician.

It depends on the findings of your fetal echocardiogram. In some cases, a physician will recommend more prenatal (before birth) tests. They may also recommend a postnatal (after birth) echocardiogram or cardiac evaluation – even if you do not have additional prenatal imaging.

If there’s a problem with your child’s heart, you will have additional tests and physician’s appointments to learn more about the abnormality in the fetal heart and to discuss the treatment options.

There are many types of CHD and each case is different. You may want to explore online resources to find definitions of common medical terms and information about how the heart works, as well as the specific type of CHD.

As you prioritize your child’s needs, it’s important to also be mindful of your own health. Many parents find they need emotional support at some point during their CHD care journey. Be sure to reach out and ask for help if you’re struggling.