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Fetal Heart Program

Covenant Maternal-Fetal Medicine functions in a role to coordinate the needed multidisciplinary approach required if a concern for your baby's development or well-being is suspected before birth. Additional members of this multifaceted team will include Covenant women's obstetrical coordinator, neonatologist, highly skilled nursing care from Antepartum (OB high-risk floor) and Labor &Delivery. These specialties are all located in one building along with the Neonatal Intensive Care Unit and the Heart Center located inside the Pediatric Intensive Care Unit.

Also Covenant Maternal Fetal Medicine has developed a very unique and highly multidisciplinary team (Perinatal Advisory Council) that will review you and your baby's specific case. This will allow facets of providers to be aware and to determine the specific needs of medical, physical, emotional and spiritual care for you, your child and family that may arise.

Fetal Echocardiography

The Covenant Maternal-Fetal Medicine Center is an American Institute of Ultrasound in Medicine (AIUM) accredited prenatal diagnosis center that employs specially trained and registered sonographers to perform first-trimester screenings and 20-week fetal anatomy screenings and any additional fetal surveillance as clinically warranted.

Hearing your new baby’s heartbeat for the first time is an exhilarating experience for an expectant mother and family. Learning that something is wrong with that heartbeat can be devastating.

Congenital heart defects are among the most common birth defects, occurring in approximately one out of every 125 live births. Many of these lesions can be identified prenatally as early as 16 to 18 weeks gestation, with optimal images obtained typically between 20-24 weeks gestation.

Our maternal-fetal medicine specialist will help to formulate the best course of treatment for the individual patient and the specific congenital heart defect.

Sometimes it's necessary to take a very close look at your baby's heart. We do this with fetal echocardiography. Our doctors and sonographers have advanced training and certification should this need arise. We adhere to strict guidelines developed by the American Institute of Ultrasound in Medicine (AIUM).

It is not necessary for all pregnancies to receive an echocardiogram. The prenatal ultrasound tests that are done prior to birth can give information about whether the fetal heart has developed with all four chambers. Most unborn babies do not require any further testing.

Situations in which a fetal echocardiogram may be necessary include, but are not limited to, the following:

  • If a sibling was born with a congenital heart defect (present at birth).
  • A family history of congenital heart disease (such as parents, aunts or uncles or grandparents).
  • A chromosomal or genetic abnormality discovered in the fetus.
  • If a mother has taken certain medications that may cause congenital heart defects, such as anti-seizure medications or prescription acne medications.
  • If the mother has used alcohol or drugs during pregnancy.
  • If a mother has diabetes or a connective tissue disease such as lupus.
  • If the mother has had a specific type of infection during pregnancy.
  • A routine prenatal ultrasound has discovered possible heart abnormalities.

Fetal echocardiograms are usually performed in the second trimester of pregnancy, at about 20 weeks. The test is sometimes done earlier in pregnancy using transvaginal ultrasound (the ultrasound probe is inserted in the mother's vagina), but will be repeated later to confirm any findings.

During the test the transducer probe will be moved around to obtain images of different locations and structures of the fetal heart. Techniques sometimes used to obtain detailed information about the fetal heart include the following:

  • 2-D (2-dimensional) echocardiography - This technique is used to "see" the actual structures and motion of the heart structures.
  • Pulse Doppler and Color Doppler echocardiography - This Doppler technique is used to measure and assess the flow of blood through the heart's chambers and valves.

Fetal echocardiography can help detect fetal heart abnormalities before birth, allowing for faster medical or surgical intervention once the baby is born. This improves the chance of survival after delivery for babies with a serious heart defect. Other tests or procedures that may be needed include the following:

  • Additional ultrasounds or echocardiography (to confirm the diagnosis, follow fetal growth and monitor fetal well-being)
  • Genetic testing/Amniocentesis - A test performed to determine chromosomal and genetic disorders and certain birth defects. The test may involve inserting a needle through the mother's abdominal and uterine wall into the amniotic sac or placenta to retrieve a sample of amniotic fluid or tissue. Relative new methods are available to maintain some of the baby's cells (DNA) circulating with the maternal blood.
  • Genetic Counselor- Counseling provided to determine if your baby's heart condition could be hereditary or associated with forms of genetic disorders

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