What to Expect From a Fetal Echocardiogram

A fetal echocardiogram is a test that allows your healthcare provider to view your developing baby’s heart. This ultrasound test uses sound waves to look at the structures of the heart and can detect a heart defect before your baby is born.

A fetal echocardiogram shows a more detailed picture of your baby’s heart than the regular pregnancy ultrasound. 

This article will explain what to expect during a fetal echocardiogram and how to prepare for one. 

Pregnant woman having sonogram - stock photo

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What Is a Fetal Echocardiogram?

A fetal echocardiogram is an important prenatal test that shows the structures of your baby’s heart. Healthcare providers perform this test to examine the heart’s rhythm and how blood flows through the heart. A fetal echocardiogram also shows the pumping strength of a developing baby’s heart. 

Reasons to Have an Echocardiogram

There are several situations when a fetal echocardiogram is needed during pregnancy. Reasons to have a fetal echocardiogram include:

It is important to note that not all heart defects can be detected by a fetal echocardiogram. Small holes in the heart and certain issues with the heart valves may not be visible with this test. 

The Procedure 

A fetal echocardiogram is usually performed in the second trimester, about 18 to 24 weeks pregnant, and does not require any special preparation. 

Before the Procedure 

Your healthcare provider will let you know if there are any special steps to take to prepare for the test. Unlike some other prenatal tests, you do not need to fast or have a full bladder before a fetal echocardiogram. 

It is helpful to hold off on using any creams or lotions on your belly on the morning of your test. If you have had any abnormal results from previous tests, such as a past ultrasound, bring any medical records that you have. 

During the Procedure 

The most common type of fetal echocardiogram is an abdominal ultrasound. This means that the healthcare provider places the ultrasound probe over your belly to obtain pictures of your baby’s heart. Your provider will start by applying a warm gel to your belly. The ultrasound probe then sends out sound waves that bounce off of your baby’s heart and produce a picture on the monitor. 

A fetal echocardiogram can also be performed using an endovaginal ultrasound. During this type of test, a small ultrasound transducer is placed inside the vagina to obtain pictures of your baby’s heart. A transvaginal ultrasound can be performed earlier in pregnancy and provides a clearer picture. 

A fetal echocardiogram is usually performed by a registered cardiac sonographer (RCS), a healthcare provider who has been specially trained in ultrasound equipment and scanning a baby’s heart. Once the procedure is finished, the test results are then reviewed by a pediatric cardiologist. This is a doctor who is specially trained in detecting and treating heart disease in babies and children. 

After the Procedure

Once your test is complete, your healthcare provider will explain how long the results should take and how to follow up with the medical team if you have any questions. Results from a fetal echocardiogram are usually ready within about 24 hours of the test. 

How Long Does a Fetal Echocardiogram Take?

 A fetal echocardiogram can take anywhere from 45 minutes to two hours. The test may take longer if your baby is in a position that makes it difficult to see the heart. Once your fetal echocardiogram is completed, results are usually ready within 24 hours.

When to Call Your Healthcare Provider

Following a fetal echocardiogram, you can expect to follow up with your healthcare provider as usual. There is no increased risk associated with this type of test. Always call if you experience any of the following symptoms during your pregnancy:

  • Vaginal bleeding
  • Severe abdominal cramping
  • Dehydration from vomiting or diarrhea
  • New-onset swelling
  • Severe headaches 
  • Blurred vision
  • Chest pain 
  • High fever


Are There Any Side Effects to Be Aware Of?

There are no known side effects or risks of undergoing a fetal echocardiogram. If the test reveals an abnormality in your baby’s heart, you may require more frequent follow-up visits and treatments. Your medical team will discuss the results with you as soon as they are ready.

What Do The Results Mean?

A fetal echocardiogram is used to detect problems in your baby’s heart. These problems could be related to how the heart is formed or the way it works. It may also show disturbances in the baby’s heart rhythm, known as arrhythmias. 

When a fetal echocardiogram reveals a problem with your baby’s heart, it is usually repeated in order to confirm the results. From there, the pediatric cardiologist will meet with you frequently to explain the heart defect and how it could affect your baby’s overall health. 

Summary 

A fetal echocardiogram is an ultrasound test used to examine the structures in a developing baby’s heart. This test can detect problems with the heart such as defects or arrhythmias. Your healthcare provider may recommend a fetal echocardiogram if you have a family history of congenital heart defects. The procedure may take anywhere between 45 minutes to two hours. Results are usually ready within 24 hours. 

A Word From Verywell 

Undergoing any type of prenatal test is nerve-racking. You may be feeling anxious about the thought of undergoing a fetal echocardiogram. Know that this is normal, and you are not alone. You may want to ask your partner or a trusted family member or friend to come with you for the test. Don’t hesitate to ask questions during the exam and once the results are ready.

Frequently Asked Questions

  • How much does a fetal echocardiogram cost?

    The National Medicare Fee Estimate for a fetal echocardiogram is $245. The cost will vary depending on your type of insurance. 

  • When should a fetal echocardiogram be done?

    A fetal echocardiogram is usually performed during the second trimester of pregnancy. It may be performed earlier if there is a concern. Your healthcare provider will explain why a fetal echocardiogram is recommended and the best time to perform it. 

  • How accurate is a fetal echocardiogram?

    A fetal echocardiogram is an effective way to screen a baby for heart disease. A 2020 review found that fetal echocardiography accurately detected congenital heart defects in about 86.5% of cases. 

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Groves AM, Singh Y, Dempsey E, Molnar Z, Austin T, El-Khuffash A, de Boode WP; European Special Interest Group ‘Neonatologist Performed Echocardiography’ (NPE). Introduction to neonatologist-performed echocardiography. Pediatr Res. 2018 Jul;84(Suppl 1):1-12. doi:10.1038/s41390-018-0076-y

  2. Nemours Kids Health. Fetal echocardiogram (for parents).

  3. MedlinePlus. Fetal echocardiography.

  4. Johns Hopkins Medicine. Fetal echocardiography.

  5. American Heart Association. Fetal echocardiogram test.

  6. Children’s Hospital of Philadelphia. Fetal echocardiogram.

  7. The American College of Obstetricians and Gynecologists. Bleeding during pregnancy.

  8. Pinto NM, Nelson R, Puchalski M, Metz TD, Smith KJ. Cost-effectiveness of prenatal screening strategies for congenital heart disease. Ultrasound Obstet Gynecol. 2014 Jul;44(1):50-7. doi:10.1002/uog.13287

  9. Mozumdar N, Rowland J, Pan S, Rajagopal H, Geiger MK, Srivastava S, Stern KWD. Diagnostic Accuracy of Fetal Echocardiography in Congenital Heart Disease. J Am Soc Echocardiogr. 2020 Nov;33(11):1384-1390. doi:10.1016/j.echo.2020.06.017 

By Carrie Madormo, RN, MPH
Carrie Madormo, RN, MPH, is a health writer with over a decade of experience working as a registered nurse. She has practiced in a variety of settings including pediatrics, oncology, chronic pain, and public health.