Fetal Echocardiogram

What Is a Fetal Echocardiogram?

A fetal echocardiogram (or “echo”) is a specialized ultrasound examination performed during pregnancy, similar to a routine obstetrician (OB) ultrasound, which focuses specifically on the unborn baby’s (also called a fetus) heart. The cardiologist will take images of the fetus’ heart structure including the heart chambers, valves and blood vessels. The blood flow throughout the heart and blood vessels is also assessed by use of Doppler "color-flow" ultrasound technique. 

Lurie Children's Fetal Cardiology team performs more than 2,700 fetal echocardiograms at multiple sites in the greater Chicago area, with a diagnostic accuracy that exceeds 95%. 

When Is a Fetal Echo Necessary?

A fetal echo is recommended after an abnormality is seen during routine OB monitoring, ultrasound or other risk factor. Fetal echocardiograms are considered in the following circumstances:

  • History of a close family relative with a heart birth defect 
  • Abnormality of the heart suggested by routine OB ultrasound 
  • Diabetes in the pregnant patient 
  • Use of reproduction assistance like in-vitro fertilization 
  • Birth defects seen in other areas of the fetus 
  • Known or suspected genetic abnormality of the fetus 
  • Exposure to chemicals or certain medicines during pregnancy 
  • Certain infections during pregnancy like rubella (German measles) 
  • Problems in twin pregnancies 
  • Abnormal fetal heart rate observed during a routine OB visit 

What to Expect During a Fetal Echo

It is not unusual for fetal echocardiograms to take up to an hour to complete due to their numerous components.  

Your doctor may ask you to drink plenty of fluids beforehand, especially if the test is being done early in pregnancy. A full bladder can help create clearer images of the baby's heart.  

The test is similar to the routine OB ultrasounds you get throughout pregnancy. You will lie on an exam table on your back. A sonographer, a healthcare professional trained in ultrasound imaging, will apply a warm gel to your abdomen. The gel helps conduct sound waves. The sonographer will then gently press a transducer, a handheld device that emits sound waves, against your abdomen. The transducer transmits sound waves through your abdomen to your baby. The sound waves bounce off the baby's heart and internal organs and travel back to the transducer. A computer uses these sound waves to create images of your baby's heart on a video screen. 
The sonographer may press on your abdomen to get a better view of the baby's heart. The sonographer may also ask you to shift positions slightly during the test. The entire procedure usually takes 45 to 60 minutes, but it can take longer depending on the position of the baby and the ease of obtaining clear images.

The gel will be wiped off your abdomen. A doctor, usually a fetal cardiologist, will review the images from the fetal echocardiogram and discuss the results with you during the same visit. If the echocardiogram reveals a heart defect, the doctor will discuss the findings, what effects it may have on the baby before and after the birth, treatment options and overall outcomes for the baby in future with you.  
Fetal echocardiograms are commonly repeated to follow the development of the heart and blood flow as the fetus grows if there are any abnormalities seen on the initial echo. Some cardiac conditions can progress during pregnancy and regularly checking on the unborn baby’s blood flow can help guide care recommendations at birth. 


Scheduling an echocardiogram requires a doctor's order and can be arranged through The Chicago Institute for Fetal Health. Please call 312.227.4747.

When fetal echocardiograms are done by our cardiologists, the patient receives a full discussion of what was seen and an interpretation of what problems may exist before they leave the office. Reports are also sent to the obstetrical caregivers involved.