Ultrasounds during pregnancy
John Stock, MD, is the medical director for pediatric cardiology at Cardon Children's Medical Center.
Question: At my last ultrasound, the OB said there was an abnormal heart rhythm and suggested a second ultrasound with a cardiologist. Does this mean there is something wrong with my baby?
Answer: Not necessarily. Ultrasounds are a great screening tool for obstetricians looking for general health information on your baby but, these same ultrasounds can miss approximately 25 percent of the newborn heart defects that later require surgery.
Your obstetrician suggested a visit to a cardiologist as a way of making sure you have the most detailed information on the health of your baby. This is a pediatric cardiologist, who specializes in heart issues for children.
The pediatric cardiologist will perform a second (or third) ultrasound, called a fetal echocardiogram. A fetal echocardiogram is a much more detailed ultrasound, taking an hour or more, that reviews your baby’s entire heart structure, rhythm and growth.
The cardiologist will then explain the findings to you. An echocardiogram may be necessary if:
- There is an abnormal ultrasound
- The mother has a disease, such as lupus or diabetes
- There are concerns of or there are abnormal genetic tests on the baby
- There are concerns of other non-cardiac abnormalities in the baby
- There is a family history of heart defects
- There is an abnormal heart rhythm for the baby
- There was an exposure to dangerous drugs early in gestation.
Scary as all this sounds, having these tests done is an advantage for the mother and baby.
In the best cases, the fetal echocardiogram will show everything to be healthy. Sometimes, the baby is in a bad position for the original ultrasound to read the heart rhythm and the fetal echocardiogram shows everything is regular and healthy.
If the fetal echocardiogram does come back as positive for fetal heart defect, it will provide you and your care team time to prepare for any special needs the baby might have at delivery. You will have more time and opportunities to discuss how the findings impact the pregnancy, delivery and care in childhood with your obstetrician and the pediatric cardiologist, as well as a neonatalogist and any other sub-specialist that might be necessary in your baby’s care following delivery.
Also, if a heart defect is found, it would be important that you deliver at a hospital that has a pediatric cardiologist and a neo-natal intensive care unit, so it might be necessary to change delivery plans completely.
So, hope for the best, and know that your obstetrician’s suggestion to see a specialist is for the benefit of both you and your baby.