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Fetal Echocardiography

Fetal echocardiography (Fetal Echo) is a highly specialized ultrasound examination of the fetal heart.


It is performed by a qualified Ob&Gyn (Fetal Medicine) specialist or pediatric cardiologist with high-end ultrasound equipment.


Prenatal screening for congenital heart defects (CHD) is very important as these are the most common fetal structural abnormalities. They occur in 8 to 12 per 1000 livebirths. Approximately half of those would be severe, i.e. they would be incompatible with life and/or would require surgery after birth.


Furthermore, the incidence of congenital heart defects in prenatl life is significantly higher. In fact, a fetus is 5 to 6 times more likely to be affected by a cardiac malformation rather than to have Down syndrome.


Therefore, the only effective way to exclude major congenital heart defects prenatally is to perform fetal echocardiography.


Fetal echocardiography can be performed at different gestational periods.The experience of the healthcare professional and the quality of the ultrasound equipment are the main factors impacting the scan.

At MC MARKOVS we work in close cooperation with our dedicated team of pediatric cardiologists who has been specifically trained in fetal echocardiography. If a congenital heart defect is detected prenatally the complex anatomy, hemodynamics and thus the prognosis are thoroughly investigated by a multidisciplinary team of experts.


Fetal echocardiography at 12-13+6 weeks of gestation

  • Fetal echocardiography can be performed as early as 12-13+6 g.w. by transvaginal or transabdominal ultrasound;
  • Transvaginal fetal echocardiography has significantly better resolution, thus better image quality;
  • Transvaginal fetal echocardiography at 12-13+6 g.w. is indicated in all high-risk pregnancies with positive family history of congenital heart defects (parents, children, etc.), gestational diabetes, teratogen exposure, etc;
  • Another important indication to perform early fetal echocardiography is the increased fetal nuchal translucency at 12-13+6 g.w.;
  • The examination can also be carried out in order to reassure the parents at the earliest possible gestational age.

Attention: Due to the early gestational age and the subsequent rapid development of the fetal heart, fetal echocardiography should always be repeated later in the pregnancy.


Fetal echocardiography between 18-23 weeks of gestation

  • The fetal heart is too small and underdeveloped in the first trimester;
  • Thus fetal echocardiography traditionally is planned at around 18-23 g.w. (optimally at 20-22 g.w.);
  • This is the examination, where a thourough assessment of the complex anatomy of the fetal heart is carried out;
  • In selected cases, it is necessary to perform fetal echocardiography in later gestation - usually at 28-32 w.g.

Attention: Not all congenital heart defects can be diagnosed prenatally.


Minor cardiac malformations, which are relatively common, can be easily missed.


In addition, a number of congenital heart defects can only be diagnosed after birth.


The leading experts in fetal echocardiography (Fetal Echo) in Bulgaria work at MC MARKOVS. For more information regrarding the possibilities of having a fetal echocardiography at MC MARKOVS at any gestation age, please contact your doctor or call at the registration desk.