Fetal cardiac sonography (fetal echocardiography) is a dedicated, extended ultrasound examination of the fetal heart performed between 18 and 28 weeks gestation to diagnose congenital heart defects (CHD). It is indicated when standard obstetric anatomy screening raises concern for a cardiac anomaly, or when maternal or fetal risk factors increase the prior probability of CHD.
The examination follows a segmental approach — systematic assessment of cardiac situs, atrial arrangement, ventricular morphology, atrioventricular connections, ventriculo-arterial connections, and great vessel relationships. All four outflow tract views, pulmonary vein connections, ductal and aortic arch continuity, and coronary artery origins are documented. Doppler interrogation characterizes flow across valves and in vessels, quantifying regurgitation, stenosis gradients, and abnormal flow patterns such as tricuspid regurgitation or reversed ductus venosus flow.
The ARDMS Fetal Echocardiography (FE) specialty is the dedicated credential for sonographers in this field. Fetal echo is performed in maternal-fetal medicine practices, pediatric cardiology departments affiliated with fetal heart programs, and level III perinatal centers. Accurate diagnosis of complex CHD in utero enables planned delivery at a cardiac surgical center and counseling of families before birth.