Prenatal Cardiology Program Referral Guidelines

Reasons for Referral for Fetal Echo

• Maternal risk factors
  • Family history of CHD, particularly in first-degree relatives
  • Maternal disease such as diabetes, lupus, PKU, hyperthyroidism
  • Environmental exposure, drug exposure particularly alcohol, seizure medicines, lithium
  • Viral infection
• Prenatal risk factors
  • Cardiac defect noted on US
  • Dysrhythmia noted by OB
  • Chromosomal abnormality suspected by US or confirmed by CVS or amniocentesis
  • Syndrome suspected by US
  • Extracardiac anomalies noted by US including 2 vessel cord, omphalocele, CCAM, diaphragmatic hernia
  • Fetal distress/IUGR
  • Nonimmune hydrops, polyhydramnios
• Indications for first trimester fetal echo
  • Increased nuchal translucency noted in the first trimester
  • Significant family history of CHD particularly complex heart disease in a previous child
  • Maternal lupus particularly if a previous child developed complete heart block