Prenatal cardiac evaluation is an essential component of modern obstetric care, aimed at detecting congenital heart defects (CHDs) before birth. This process typically involves the use of advanced imaging techniques, primarily fetal echocardiography, to assess the structure and function of the developing fetal heart. The importance of prenatal cardiac evaluation cannot be overstated, as congenital heart disease is one of the most common types of birth defects, affecting approximately 1 in 100 live births. Early detection allows for better planning and management of both the pregnancy and the postnatal period, potentially improving outcomes for affected infants.

An evaluation will include a fetal echocardiogram and a consultation with the physician. A fetal echocardiogram is an ultrasound test performed to evaluate the heart of a baby in detail during pregnancy. An obstetrician will request this study when there may be an increased risk of congenital heart disease (which is a birth defect of the heart) in the baby. Reasons include:

  • A close relative with congenital heart disease (such as a parent or sibling)
  • Concerns noted on a screening ultrasound (difficulty visualizing heart structures or other abnormalities noted in the fetus)
  • A genetic abnormality in the fetus
  • Certain maternal health problems associated with heart disease (such as diabetes or lupus)
  • An abnormal fetal heart rhythm or heart rate
The evaluation is typically performed in the second or third trimester and there are times that it is repeated during the pregnancy. Fetal echocardiography helps to identify fetal heart abnormalities prior to birth which allows for better planning for the delivery and for the immediate care of the baby after birth.