Twin pregnancy brings extra excitement and extra questions too. The doctors may recommend additional monitoring to carefully observe the overall cardiac growth and development of the two babies in the mother's womb.
All doctors recommend a fetal echocardiogram (fetal echo) in some twin pregnancies. It is a detailed, non-invasive ultrasound test that evaluates an unborn baby's heart structure and function. The doctor checks each baby's heart condition separately with extra care.
What is really meant by the Twins Fetal Echo? Why might it be recommended? When is it performed? What does the doctor look for? And does having twins automatically mean that a fetal echo is required? Let’s learn all about this step by step:
What Is a Fetal Echo?
The fetal echo is used to examine the fetus' cardiac (heart) health, overall development and growth, and all the functions of the heart during the examination. The specialist carefully examines each part and each chamber of the heart, particularly for each baby. It can be done between 18 and 22 weeks of pregnancy, though it can be done earlier if high risks are present, using sound waves to create moving pictures of the heart's chambers, valves, and blood vessels.
What Is Checked During a Twins Fetal Echo?
1. Heart Rate and Rhythm:
The doctor checks the baby's heart rate and rhythm to identify if there are any abnormalities in the heartbeat and rhythm.
2. Four Chambers of the Heart:
During the (fetal echo) scan, the doctor examines the four main chambers of the heart:
Right atrium
Right ventricle
Left atrium
Left ventricle
3. Heart Position:
The doctor checks the heart position very carefully to find out if there is any abnormality in the baby's cardiac activity; the (normal range is between 25° and 65°).
If the heart is in the right chest, it can be said to be dextrocardia.
If the heart is located in the heart and sits centrally in the chest, it can be said as Mesocardia.
4. Ventricular Outflow Tracts:
In the fetal echo scan, the doctor checks and observes the two main blood tracts and their functions: Left Ventricular Outflow Tract (LVOT) (it connects the left lower heart room to the aorta), and Right Ventricular Outflow Tract (RVOT) (it connects the right lower heart room to the pulmonary artery)
5. Great Arteries:
It involves checking the size, path, and connections of the pulmonary artery, aorta, and ductus arteriosus to ensure proper blood flow
6. Heart Valves:
A fetal echo scan is also used to examine the baby's heart valves, including the aortic and pulmonary valves and a few additional valves, to determine if they are the correct size, moving properly, and directing blood forward without any abnormal leaking.
7. Septum:
The walls separating the chambers of the heart are evaluated for abnormalities that may be visible during the examination.
8. Blood Flow & Overall Cardiac Function:
The doctor checks the blood flow and overall cardiac function using color and spectral Doppler.
Color Doppler: It maps the direction and speed of blood flow
Spectral Doppler: it measures exact blood velocities across heart valves.
9. Overall Cardiac Function:
Chamber Sizing: the doctor checks for the heart chamber size and the wall thickness of the left and right ventricles.
Contractility: It mainly measures how the heart muscle squeezes and relaxes during every heartbeat.
Rhythm Check: One of the main things the doctor examines is the heart rhythm; it might be the normal heart rate of a fetus in the mother's womb, typically 110 to 160 beats per minute (bpm) during the second and third trimesters.
Conclusion:
A twin pregnancy can bring additional excitement, and also require more careful monitoring throughout pregnancy; Twins Fetal Echo is a specialized ultrasound examination that provides a detailed assessment of each baby's heart, including its chambers, valves, major blood vessels, blood flow, rhythm, and overall cardiac function; the examination helps the fetal cardiac health condition through looking closely at the heart of each twin individually.
Common Questions:
Every Twin Pregnancy Need a Fetal Echo?
The answer is no because the decision depends on the individual pregnancy and whether there are clinical indications from your personal doctor for a detailed fetal cardiac assessment.
About the Doctor
Dr. Naren Satya
Consultant Radiologist
Naren Ultrasound and Fetal Medicine Center, Visakhapatnam
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