fetal echo
Indications for fetal echocardiography
We present below the classic indications for fetal echocardiography based on recommendations published in Circulation (2014). However, currently most experts agree that fetal echocardiography is recommended for every pregnant woman if possible.
- diabetes (HbA1C> 6%),
- phenylketonuria,
- systemic diseases (mainly with positive anti-Ra, anti-La antibodies),
- infections during pregnancy,
- other comorbidities in history,
- therapy with converting enzyme inhibitors, lithium, retinoids, antiemetics, serotonin reuptake inhibitors, vitamin K antagonists, non-steroidal anti-inflammatory drugs,
- in vitro fertilization,
- thickened fetal nuchal translucency / suspicious DV readings in late first trimester of pregnancy,
- extracardiac defect or genetic syndrome that may coexist with WWS,
- cases of monochorionic twin pregnancies, especially in the complicated form or other multiple pregnancies with a monochorionic component, regardless of gestational age;
- fetal arrhythmia,
- FGR,
- fetal oedema,
- anomaly of the venous system [congenital absence of ductus venosus (DV), Galen vein malformation (GVM), arteriovenous malformations
Early echocardiography of the fetus
Early fetal echocardiography is of great importance for the early exclusion of the most clinically relevant Congenital Heart Defects (CHD) for the baby as early as the first trimester of pregnancy. We are among the world’s pioneers of this method of scanning and have contributed to the worldwide bibliography of the issue. In principle, the examination is performed using a high-frequency transabdominal ultrasound transducer (we use a range of 3-10 MHz for this purpose). In some patients, it is necessary to supplement imaging with a transvaginal transducer. This depends on the individual scanning conditions, i.e. structure of the uterus, position of the fetus, amount of amniotic fluid, presence of postoperative scars. The scan protocol is based on a protocol of sequential segmental analysis of the cardiac structure. We supplement it with blood flow mapping using Doppler techniques, i.e. colour, power and spectral Doppler. We have tremendous experience in image optimisation for this sublime and guarantee that our image will be much clearer than in many other medical practices. We perform the examination between the 11th and 16th week of pregnancy.
Fetal echocardiography
Consists of a detailed assessment of the structure, function and prognostic parameters concerning the fetal heart and its circulatory system. To assess the structure of the heart, we use the protocol of sequential segmental analysis adopted in paediatric cardiology, which allows a precise assessment of the elements that build the structure of the heart and their interconnections according to the direction of blood flow. In addition, we carry out precise functional determinations of atrioventricular, arterial and foramen ovale flap function, as well as diastolic, systolic and global myocardial function. The examination is complemented by an assessment of the fetal peripheral vessels. The optimal timing of the examination is 24-26 weeks of gestation, provided that a detailed screening examination of the first and second trimester has been performed so far and has not revealed anomalies. If there were no such abnormalities, a thorough fetal echocardiographic scan will be carried out from the 18th week of pregnancy due to the premium segment ultrasound equipment we use, equipped with a set of multiple transducers allowing scanning of different patients.
Follow-up echocardiography in cases of identified fetal cardiovascular pathologies.
Follow-up fetal echocardiography is of great importance in cases of established Congenital Heart Defects. The majority of these anomalies fortunately do not undergo evolutionary changes during pregnancy, however, in certain cases, follow-up examinations are invaluable. Examples include cases of D-Type Transposition of the Great Arteries (D-TGA), which require follow-up in the late third trimester, as does Hypoplastic Left Heart Syndrome (HLHS). In follow-ups, we assess prognostic factors depending on the type of anomaly so that the place and time of delivery can be well planned to maximise the chances for the baby.
Fetal arrhythmias
Fetal echocardiography is used to accurately assess and qualify for treatment during pregnancy of fetal arrhythmias in cases such as supraventricular tachycardia or congenital heart block. We have been providing treatment during pregnancy for such conditions for many years.
Tumours of the fetal heart
We were the first in Poland to successfully apply treatment during pregnancy that resulted in the disappearance of tumur foci in the fetal heart and a reduction in similar brain lesions. The qualification for such treatment is based on medical interdisciplinary cooperation. If fetal heart tumurs are found, we would be happy to perform a detailed echocardiogram and consult accordingly.
TTTS (Twin-To-Twin-Transfusion-Syndrome)
The finding or suspicion of TTTS requires a detailed echocardiographic examination because this anomaly of the placental vessels leads to significant circulatory anomalies, especially in the recipient fetus. We have access to both a standard invasive method of treating this syndrome with fetoscopy and a novel non-invasive method developed in the UK.
Amniocentesis and genetic testing
We safely perform such tests on site to exclude the genetic background of congenital heart defects
Interdisciplinary consultation
Examinations reimbursed by the National Health Fund
under application
Free fetal echocardiography as part of training for doctors
We regularly hold training sessions for doctors during which we provide free fetal echocardiography examinations and consultations. The largest of these, the Fetal Cardio Cracow, takes place regularly in early December each year. Please contact us by email if you are interested.
