TIMINGS FOR FETAL ECHO
At our centre we prefer to do Fetal Echo by 18 weeks. It can be done at time beyond this also. There is significant advantage to the earlier timing including better imaging. This obviously has been possible by advances made in technology. Additionally, in case a very major abnormality is picked up possibility of termination before 20 weeks is also available.
Though most lesions can be picked up at this stage of pregnancy but a few may not be:
1. Valve Lesions: typically, the valve lesions especially valve blockages (called stenosis) start as a mild problem at 20-24 weeks. They may be so mild; they may not be picked up. And therefore a repeat assessment at 28 weeks or after birth may confirm these diagnoses. Conditions included in this subset include Pulmonary Valve Stenosis and Aortic Valve Stenosis.
2. Coarctation of Aorta: This is blockage of the main tube taking blood into the lower half of the body. This lesion starts at 28 weeks or sometimes maybe earlier. It gradually progresses beyond 28 weeks and typically can be suspected any time beyond that.
3. Cardiac Conditions which show up only indirectly: there are a few lesions which cannot be diagnosed by direct visualisation but by its indirect effects: Aorto Pulmonary Window, Aorto Pulmonary Collaterals, Coronary Cameral Fistula.
Your babies heart is a very complex structure. It is so complex that the whole body's organs can be commented by one person but the final call on the heart is taken by a Pediatric Cardiologist.
The evaluation is usually done at 18 weeks of pregnancy. Ability to give an opinion which is 90% or more accurate is what is needed. All Pediatric Cardiologists also maynot have as much experience in this field.
There are several reasons why a Pediatric Cardiologist is considered the most appropriate person for purposes of a fetal Echo:
-Diagnosed before birth
-Counsel before birth
-Even Prior to 20 weeks
-Manage them in Utero or at birth