Findings, Hx Flag Need for Fetal Echocardiogram. (Fetal Hydrops, Maternal Cardiac Disease).

PALM BEACH, FLA. - Although few obstetricians will ever do a fetal echocardiogram themselves, knowing when to ask for one and how to guide their patients through the results is a valuable asset, according to one expert.

If an anomaly is detected, the referring physician is encouraged to continue the necessary monitoring and antenatal testing to track its progression until delivery "Our goal is to not exclude the referring physician and, in fact, to have them go ahead and do the delivery when the time comes," Dr. Deward Voss said at an ob.gyn. meeting sponsored by the University of Chicago.

Congenital cardiac anomalies occur in 411 of every 1,000 live births, said Dr. Voss, a maternal-fetal medicine specialist at Good Samaritan Hospital in Cincinnati.

Physicians should suspect a higher risk of cardiac anomalies in women with metabolic disorders such as diabetes mellitus or phenylketonuria; exposure to a known cardiac teratogen such as alcohol, anticonvulsants, retinoic acid, or lithium; exposure to viral teratogens such as rubella, parvovirus, or Coxsackie virus; or maternal autoantibodies as in lupus erythematosus or Sjobgren's syndrome.

If the mother has cardiac disease, the risk of a cardiac defect in the fetus may be as high as 12%, whereas it's 5%-10% if the father has heart disease or the mother has borne an affected child or fetus.

Certain findings on routine obstetric sonograms are definite indications to order a fetal echocardiogram. These findings include any extracardiac malformation, the presence of fetal ...