Fetal echocardiography: A nine-year experience at a single tertiary center

Fetal echocardiography is a vital diagnostic tool used during pregnancy to evaluate the structure and function of the fetal heart. It allows for the early detection of congenital heart diseases (CHDs) and fetal arrhythmias, enabling timely prenatal counseling, perinatal planning, and therapeutic interventions when necessary. While routine obstetric ultrasounds may detect basic structural anomalies, fetal echocardiography provides more detailed anatomical and functional information, particularly in high-risk pregnancies. This study presents a nine-year experience of fetal echocardiography at a tertiary center, focusing on diagnostic accuracy, clinical contribution, and postnatal outcomes.

We retrospectively analyzed 405 fetuses who underwent fetal echocardiography between March 2016 and March 2025. All evaluations were performed by an experienced pediatric cardiologist using standard imaging protocols. Fetal cardiac findings and postnatal confirmation data were assessed.

Major structural cardiac anomalies were identified in 48 fetuses (11.9%), with the most common being Tetralogy of Fallot and Transposition of the Great Arteries. Minor findings such as echogenic intracardiac focus, premature atrial contractions, and small ventricular septal defects (VSDs) were seen in 104 cases (25.7%). Significant arrhythmias, including supraventricular tachycardia and complete heart block, were detected in 14 cases (3.5%).

Fetal echocardiography is a reliable, non-invasive method for the early and accurate diagnosis of fetal cardiac anomalies. It facilitates appropriate prenatal referral and postnatal care planning, ultimately improving neonatal outcomes.