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Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode recording; follow-up or repeat study

CPT4 code

Name of the Procedure:

Echocardiography, fetal. Also known as a fetal echocardiogram or fetal echo.

Summary

A fetal echocardiography is an imaging test performed during pregnancy to evaluate the heart of the unborn baby (fetus). This procedure uses ultrasound waves to create detailed images and assess the baby's heart structure and function in real-time.

Purpose

Fetal echocardiography is used to detect congenital heart defects and other cardiovascular abnormalities in the fetus. The primary goal is to diagnose any issues early so appropriate planning and treatment can be arranged before or immediately after birth.

Indications

  • Abnormal results from a standard prenatal ultrasound.
  • Family history of congenital heart defects.
  • Maternal conditions such as diabetes, lupus, or infections.
  • Fetal conditions like irregular heart rhythms or other genetic syndromes.
  • History of increased nuchal translucency detected during the first trimester screening.

Preparation

  • Typically, no special preparation is needed.
  • Patients may be asked to have a full bladder for better imaging quality.
  • Wear comfortable clothing that allows easy access to the abdomen.

Procedure Description

  1. The patient lies on an examination table.
  2. A special gel is applied to the abdomen to help transmit ultrasound waves.
  3. A transducer (a handheld device) is moved over the belly, emitting sound waves that create images of the fetal heart on a monitor.
  4. The technician or healthcare provider captures real-time 2D images and may use M-mode recording if needed for detailed analysis.
  5. Image documentation is done for further review and comparison in follow-up studies.

Duration

The procedure usually takes about 30 to 60 minutes.

Setting

  • Performed in a hospital or an outpatient clinic equipped with ultrasound facilities.

Personnel

  • A pediatric cardiologist or a specialist trained in fetal echocardiography.
  • Ultrasound technician or sonographer.
  • Occasionally, an obstetrician might also be present.

Risks and Complications

  • The procedure is noninvasive and has minimal risks.
  • Rarely, prolonged exposure could cause slight warmth or discomfort from the gel and probe.

Benefits

  • Early detection of heart defects can significantly improve treatment outcomes.
  • Helps in planning for any necessary interventions post-birth.
  • Provides reassurance if no issues are found.

Recovery

  • No recovery time needed as it is a noninvasive procedure.
  • Normal activities can be resumed immediately after the exam.

Alternatives

  • Standard prenatal ultrasound: Less detailed for heart diagnostics.
  • Genetic testing: Can indicate potential issues but does not visualize the heart.
  • MRI: Another imaging option but less common for fetal heart assessment.

Patient Experience

  • Patient might feel slight pressure from the transducer moving across the abdomen.
  • The gel may be cold at first but generally does not cause discomfort.
  • Minimal discomfort, and the procedure is generally well-tolerated.

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