For years fetal echo is done at 22 to 24 weeks.

But, after 20 weeks, legal hurdles can make medical termination of pregnancy (MTP) an herculean task.

Things and times have changed.

Better machines

Machines have improved by dramatically over last 10 years.

• Advances in technology
• Pure wave probes
• Higher resolution
• More vivid color imaging
• Introduction of live 3D and 4D scans.

Experience of Doctor

• Over last three decades , operators have gained vast experience.
• Better understanding of disease process.
• Collaborative efforts of different streams of medicines.

Early Fetal echo: At 14 to 18 weeks

American Heart Association 2014 guidelines.

Most complex heart lesions can be diagnosed with high sensitivity at 14 to 18 weeks.

Early fetal echo can diagnose

• TOF Tetralogy of Fallot
• TGA Trans position of great arteries
• DORV Double outlet right ventricle
• TA tricuspid atresia, Single ventricles
• AVSD Atrio venticular septal defects
• TAPVC Total anomalous pulmonary venous drainage
• HLHS Hypoplastic left heart syndrome
• PA IVS Pulmonary atresia intact IVS, etc.

What are advantages of early fetal echo before 20weeks?

• It is very delicate and sensitive issue.
• A thorough counseling of parents is vital.
• (Nature of disease, surgeries required, long term outcome etc)
• Understand difficulties to come to conclusion.
• Parents need time to think and decide.

• Empathy is the way to go.
• Respect free will.

• A decision can affect ENTIRE FAMILY.
• LETS UNDERSTAND ALL FACETS OF PROBLEM.

• Informed decision making is the way to go.
• An decision in haste can be misinformed or away from
• logic

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