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Paediatric Cardiac Sciences

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Fetal Cardiology

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Sir H N Reliance Foundation Hospital introduces the new “ Fetal Cardiology Unit” with Dr Anupama Nair as a full time and dedicated Fetal Cardiologist. She is an expert in this field and has received her formal training in Fetal Cardiology from the three best centers of the world namely Boston Children’s hospital, U.S.A and Guy’s & St Thomas hospital, London, UK and Sickkids Hospital Toronto, Canada.

“Fetal cardiology” is a specialised branch of medicine dealing with the evaluation and management of cardiac problems in the unborn baby while still in the mother’s womb.

Fetal cardiology offer a comprehensive approach to the patient including facilities for diagnosis, counseling and treatment of various types of heart problems in the developing fetus. This gives a wider range of management options to the parents and also gives them enough time to take decisions.


Fetal Cardiology includes the following services:

  • Expert evaluation and diagnosis of fetal heart abnormalities by means of advanced FETAL ECHOCARDIOGRAPHY
  • Detailed counseling of your baby’s heart diagnosis and treatment options
  • Personalized delivery planning
  • Fetal heart therapies in selected cases
    • treatment of fetal arrythmias in utero
    • fetal cardiac interventions
  • Comprehensive newborn care provided by a team of an expert pediatric cardiologist, neonatologists and intensivists
  • Fetal Echocardiography
  • Fetal Heart Therapies

What is fetal Echocardiography ?

Fetal echocardiography is a highly specialized and detailed evaluation of the baby’s heart while still in the mother’s womb. Done best and ideally by a Fetal cardiologist or pediatric cardiologist, it involves a detailed ultrasound evaluation of the structure (valves, chamber, partitions, blood vessels) of the baby’s heart. It also assesses the regularity of the fetal heartbeats and the pumping function of the heart. Fetal echo makes it possible to identify in the fetus various structural heart defects as well as heartbeat abnormalities and thus provide appropriate care.

How long does it take to do a Fetal Echo?

On an average, it takes 20-30 minutes for a fetal echo study. However it might take longer if the baby has a complex heart defect or the fetal position is not favourable.

What is the ideal time for Fetal Echocardiography?

The ideal time for this test is between 18-20 weeks of gestation. In some very high risk cases, it may be done as early as 14-16 weeks of gestation.

How is Fetal echocardiography done?

Fetal echocardiography utilizes the same principle of ultrasound as in routine obstetric scan but is more detailed and focused on heart. A routine obstretic scan includes a basic screening of the heart which detects few major cardiac abnormalities. Thereafter a fetal echo by an expert as in our center involves a detailed evaluation including various views and advanced software and technologies like 3D imaging, Tissue Doppler assessment etc.

Also fetal echocardiography does not require the pregnant female to be in a fasting state or to have a full bladder, thus making it quick and convenient.

Who should do a Fetal Echocardiography?

Fetal echocardiography should ideally be done by a Fetal Cardiologist or a pediatric cardiologist who have an in-depth knowledge of the wide spectrum of congenital heart defects. At our center, this is done by a dedicated Fetal Cardiologist –Dr. Anupama Nair who is an expert in this field.

What are the indications for Fetal Echocardiography?

At present, Fetal Echocardiography is recommended in certain high risk pregnancies and is done for specific maternal or fetal indications.

Maternal indications include –

  • Family history of congenital heart defect
  • Maternal metabolic disorders like diabetes mellitus or phenylketonuria
  • Autoimmune disorders with antibody positive
  • Maternal exposure to teratogenic drugs, substances
  • In-vitro fertilization pregnancies
  • In-utero infection
  • Patients choice

Fetal indications include –

  • Abnormal fetal cardiac screening on obstretic ultrasound
  • Abnormal heart rate (slow or fast) or rhythm
  • Chromosomal abnormalities
  • Extra-cardiac abnormalities
  • Twins
  • Non immune hydrops foetalis
  • Increased nuchal translucency
  • Polyhydramnios

Does fetal echo scan has any harmful effect?

Fetal echocardiography is done using the common ultrasound principle and is very safe. It has no harmful effect on the fetus even if performed multiple times in pregnancy.

What is Fetal Arrhythmia?

These are disorders of the fetal heart rate which can be abnormally slow or fast and can prove life threatening to the baby.

Can Fetal Arrhythmias be treated before birth?

Yes. Fetal arrhythmias can be treated before birth by using various drugs given either transplacentally through mother or directly into the baby. This markedly reduces the risk of death and hydrops.

What is Fetal Cardiac Intervention?

These are procedures done within the baby’s heart in certain conditions while the baby is still in mother’s womb. It includes dilating the heart valves or placing a stent.

How does Fetal Echo by Fetal / Pediatric Cardiologist helps better

There are immense benefits and this is the only scientific way to approach a mother-to-be with an abnormal fetal heart.
To quote few of them:

  • Diagnosis is more accurate about the exact nature and extent of the heart defect along with a surgical perspective
  • Having a thorough understanding of all congenital heart defects known to science, and the exact natural history of them if we do not treat in timely fashion, Fetal cardiologists can provide accurate counselling and the proper roadmap for managing the child from the beginning to post-delivery care
  • As the same Fetal cardiologist who did the Fetal echo, also does the intervention, fetal cardiac interventions if needed can be done at the right time. This provides the continuity of care.
  •  The same fetal cardiologist will be taking care of babies after delivery in postnatal period providing again the continuity of care
Partners in care

Dr. Bharat Dalvi

Dr. Bharat Dalvi
Paediatric Cardiac Sciences
MD, DM (Cardiology), Clinical Fellow - Cardiology, Children's Hospital, Boston USA, Cleveland Clinic Foundation International Medical Scholar, USA, 1997
Call us Call us on 022-61305000

Dr. Manglesh S. Nimbalkar

Dr. Manglesh S. Nimbalkar
Paediatric Cardiac Sciences
MBBS, MD - Paediatrics Awarded prestigious fellowship by Society of Cath Interventions, for performing over 2,400 Angiography procedures
Call us Call us on 022-61305000

Dr. Kshitij Sheth

Dr. Kshitij Sheth
Paediatric Cardiac Sciences
MBBS, DCH, DNB (Paediatrics), FNB - Paediatric Cardiology
Call us Call us on 022-61305000



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