When?

In the Indian context the ideal time for undergoing fetal echocardiography would be at a gestational age of 18-20 weeks. In few special situations where a mother has an immune disorder (SLE-systemic lupus erythematosus), a fetal screening echocardiography should be done at the age of 13-14 weeks of gestation to look for conduction defect in the babies heart. Here repeated cardiac screening of baby is required at least weekly and till the age of 24-26 weeks of gestation.

In western countries, the ideal age for fetal echocardiography is considered to be between 21-24 weeks. This difference in approach is due to the legal regulations for medical termination of pregnancy. In India, the MTP is allowed till the age of 20 weeks of gestation only. So all the effort should be made to diagnose the major cardiac defect should be done before this time.

Rarely a repeat fetal echo may be advised, where images acquired are not of the quality at an early age then a repeat fetal echo is performed at a later age. the major cardiac anomalies need to be ruled out as much as possible at earlier fetal echo.

In some instances where fetal echo was not advised at early gestation as there was no indication and no suspicion of a heart defect on obstetric sonography was present, but at a later USG has shown a heart defect or a possible heart defect, a referral for fetal echo would be given at later gestational age. The advantage of having a diagnosis here is that the management of this heart defect can be planned and a timely cardiac care can be provided. Moreover, this also helps parents to choose a place to deliver the baby with consideration of urgency with which the baby will require NICU and cardiac care.