Fetal Echocardiography Fetal Echocardiography is a relatively newer modality of obstetric investigation which have come into vogue over the past few years. An experienced fetal cardiologist scans the heart of the baby using special probes through the maternal abdomen. Congenital heart disease affects nearly 1-2 % of all fetuses. Incidence of serious heart disease is far higher compared to any other congenital defect or genetic syndrome like Down’s Syndrome. Thus it is essential to scan the fetal heart during pregnancy. Ideal time to perform a fetal cardiac scan is between 18-22 weeks of gestation. The most important indication is an abnormal anomaly scan where a congenital heart disease is suspected. Fetal indications include twin pregnancy, other structural defects or a suspected genetic syndrome. Some maternal indications are advanced age at pregnancy, in-vitro fertilization, maternal diabetes etc. Fetal echocardiography not only detects congenital structural cardiac defects but also cardiac function abnormalities. Detection and management of fetal arrhythmias also forms a very important part of the fetal cardiac evaluation. Fetal echocardiogram includes detailed counseling of prospective parents regrading further planning of pregnancy and treatment options after birth in case of a serious congenital heart disease. Risk of recurrence in future pregnancies are also discussed. Like ultrasound, fetal echocardiogram does not expose the fetus to any harmful radiation. Thus even multiple scans can be performed if necessary without increasing any risks to the fetus.