Who needs a fetal echocardiogram?

Contemporary OB/GYN Journal, Vol 68 No 01, Volume 68, Issue 01 / Yalda Afshar, MD, PhD, Mark Sklansky, MD

Congenital heart disease (CHD) is the most common major birth defect and represents the leading cause of infant death from a congenital anomaly.1,2 In high-resource settings, CHD accounts for roughly 4% of all neonatal deaths and 30% to 50% of deaths related to congenital anomalies.1,2 The incidence of CHD among live births is 6 to 12 per 1000 and is likely an underestimate given both spontaneous and elective terminations with CHD.3,4 Identified risk factors for fetal CHD are broadly placed into 3 categories: maternal factors, fetal factors, and familial risk factors. Considering these risk factors, patients with increased risk should be considered for fetal echocardiography.5 Here, we review the tenets of fetal echocardiography, including the risks, benefits, and the indications for appropriate referral (Figure 1).

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