Fetal echocardiography

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Marie-Ange Demory
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fetal echocardiography

L'fetal echocardiography It is a specific and accurate exam that studies the anatomy of the baby's heart in the belly, the doctor may request it when there is a risk of malformations or diseases of the heart due to heredity, pregnancy infections or maternal pathologies, or to check the heart more thoroughly.





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Already during the morphological ultrasound, which is usually performed around the 20th week of gestation, the ultrasound system observes the heart and all its structures, but sometimes it is necessary to do an extra investigation. At that point the woman is directed to a XNUMXnd level center where fetal echocardiography is performed. It is not an invasive test and is used to understand if the heart muscle is developing correctly and to exclude any malformations and heart disease, already suspected during the morphology or for chromosomal alterations or only for scruple in the case of maternal diseases.

Fetal echocardiography when to do it

The gynecologist, on the basis of maternal information or on the basis of the results of the prenatal diagnosis and / or morphological ultrasound, may decide to have this examination followed. This test is generally required in case of:



  • Infections and diseases of the mother

if mom has contracted gods virus such as Cytomegalovirus, Coxscakie or Rubella, if you have type 1 diabetes and are insulin dependent, if other maternal diseases such as phenylketonuria or other autoimmune diseases are present, if teratogenic drugs were taken during the 1st trimester, if in the family there are cases of heart disease or cardiac malformations

  • Suspected morphological

if during the morphological ultrasound the suspicion of a congenital heart disease, if the amniocentesis has resulted in a chromosomal alteration, if the nuchal translucency is greater than the 99th percentile, if the growth of the fetus has slowed down, if a fetal arrhythmia (abnormal heart beat) has occurred.

Even in monochorionic twin pregnancies it is recommended to carry out an accurate study of the heart structures of the fetuses

Fetal echocardiography at how many weeks

Generally this examination is done after the morphological ultrasound and therefore not before the 20st week. In cases where a risk factor already exists (see maternal causes) it is performed directly in conjunction with the same morphology. Before the 20th week it is not recommended because it does not guarantee a certain and precise diagnosis, while from 20 weeks onwards it can be performed at any time



Read also: Flowmetry, what it is and when it is done

How fetal echocardiography is done

Like a normal ultrasound, it uses the ultrasound and through the probe connected to the ultrasound it allows to transmit the information that will be bounced on the monitor showing us the cardiac structures. It is neither dangerous nor annoying for both mother and baby; it lasts on average about 20/25 minutes if there are no unfavorable conditions such as poorly positioned baby, little amniotic fluid etc. There are two evaluations: a primary one, which studies its anatomy, and a secondary one, which studies its functionality and is performed with the aid of color and pulsed Doppler, to study the blood flows.

Its main function is to allow an accurate and almost complete study of theanatomy of the fetal heart.

While with the morphological ultrasound, which all mothers perform, the lower part of the heart is studied, that is the one occupied by the atria and the ventricles, with this specific examination it is also possible to examine the upper part of the fetal heart, that is the one constituted by the aorta. , from the pulmonary artery and from the heart valves, thus having the possibility to discover most of the congenital pathologies which are often borne by these structures. In practice it gives the possibility to exclude or confirm any presence of congenital heart disease or malformations: with echocardiography we can discover up to 90% of heart malformations with a diagnosis accuracy of 90% (however it is important to know that some pathologies develop in a secondary period, i.e. after the examination has been performed, and that due to the unfavorable position of the fetus or excessive maternal adiposity it is possible not to have a clear view of the facilities).
 

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