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Ultrasound showed normal heartbeat and normal development of the fetus. Should I be worried?

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Practicing since : 1981
Answered : 922 Questions
Hi there. I just got the results from my 20 week prenatal ultrasound, and they said that my baby may have a heart axis that is slightly to the right. They said that they can see all the chambers of the heart, and all the other workings of it, and everything appears very normal. They say it is likely due to the baby's positioning during the exam, but it still has me worried. The baby's heart beat is normal, and my doctor has commented that it has a very strong, healthy sound and that the baby is developing completely normally. Is this something to worry about, and what will it mean for my baby long term if it is a problem? Thanks :)
Posted Fri, 22 Mar 2013 in Pregnancy
Answered by Dr. Anil Grover 3 hours later
Hi there,
Thanks for writing in.
I am a qualified and certified cardiologist and have reasonably large experience in doing fetal echocardiography, some of which has been published in medical journals. I read your mail with diligence. In two words my advice can be summed up: Don't Worry. Reason I am writing as baby in the womb of the mother has to depend on blood supply from mother therefore, there are pre requisite channels of communication in the baby which are necessary for its living for the lungs(which oxygenate the blood become functional only after birth). Therefore, the dictum is always confirm what you see on fetal ultrasound confirm or discard it after birth. When every thing appears normal it is going to be normal; with only defects which can not be diagnosed in fetal heart that is inter-atrial connection or patent foramen ovale (again required by fetus for its survival)inter-pulmonary artery to aorta communication (same reason as above). These close within a day or so after birth when baby's lung become functional with first cry. Right Axis is normal for fetus and it will take at least 4 weeks after for getting to normal axis. So, there no cogent reason(s). If you have any further question please feel free to ask. I shall be happy to answer. Good Luck.
With Best Wishes

Dr Anil Grover
Above answer was peer-reviewed by
Follow-up: Ultrasound showed normal heartbeat and normal development of the fetus. Should I be worried? 19 minutes later
Thank you so much for answering me back. I truly appreciate it. Your advice has been very comforting. I would just like to clarify, that if it shows that the axis in the baby's heart does indeed go slightly to the right, that it can take up to 4 weeks following birth for it to go to a normal position? And this is quite common in fetuses? Please let me know. Thank you very much for your time :)
Answered by Dr. Anil Grover 1 hour later
Thanks for writing back.
Well, if you doctor was referring to EKG axis of baby, which can also be recorded it is normally to right. For baby is amniotic fluid sac. It is not breathing yet its blood gets oxygenated from mother; herein placenta acts as lungs for the fetus. So in presence of non functioning lungs the axis is right. In fact in fetus all 4 chambers appear of the same size. When lungs start functioning the blood flow to them commences, thereafter the right side of heart is facing less pressure to work on to. To become akin to adult (though I do not believe children more so infants are miniature adults) circulation pressure the time taken is 4 weeks. That is NORMAL. So what you have so perceptively written is technically correct. In infants, children, adolescents and older adults heart lies in mid line behind the breast bone. If you have any further query I shall be happy to answer. It is a pleasure interacting with you. Regards

Dr Anil Grover
Above answer was peer-reviewed by
Follow-up: Ultrasound showed normal heartbeat and normal development of the fetus. Should I be worried? 34 minutes later
Thank you so much doctor. The axis issue in my baby was identified (though not clearly yet) through the use of ultrasound. There have been no EKG readings taken, just to clarify that portion. The last question I have is based on the meaning of the axis itself that they are referring to. Are they referrring to the XXXXXXX axis within the heart that controls input and output of blood through the heart through electrical pulse, or the positioning of the heart itself within the chest cavity? Just want to make sure I am clear on it. Thank you so much. It has been a pleasure interacting with you also :)
Answered by Dr. Anil Grover 1 hour later
Thanks for getting back with a very pertinent question. Cardiologists like me infer EKG by using Doppler examination, however, that is useful in telling about rate and rhythm of the fetal heart beat. EKG of the baby can be done after the labor has set in by scalp electrodes which obviously is not the situation here. Therefore, I am certain here doctor or technician who has done the echo would be referring to rotation of heart and axis heart is right sided, That, I can not comment without seeing the recording of echo and Doppler examination. However, if you have been told by your treating doctor that structurally and functionally there is no abnormality of the heart then no further test is require immediately. Only an echocardiography of the new born has to be done for our satisfaction. Good luck.

To answer your question, irrespective of electric conduction when structure of heart is normal that does not become an impediment to normal blood flow in the heart. In your words the electrical conduction does not affect blood flow in fetus when heart is normal. If you can send me doctors notes to my email id: YYYY@YYYY . I will get back to you at the earliest;.

Anil Grover
Above answer was peer-reviewed by
Follow-up: Ultrasound showed normal heartbeat and normal development of the fetus. Should I be worried? 15 hours later
Thank you so much doctor. You have been more helpful than I could have ever imagined. I do believe they are talking about a rotation, or positioning, of the heart. As I said, there has been no EKG performed. The doctor did state that functionally and structurally the heart was normal, as assessed by the radiologist who reviewed the ultrasound recordings. They also said in the findings that the right axis deviation was "slight", so I am assuming that means minor. I don't know if that makes a difference or not. I am having another follow up ultrasound on March 21 (two weeks time), to make sure that this is in fact the case, or whether it was a misconception based on the positioning of the fetus (which is what they are assuming at this time). Once that is performed, I would love to send the results to your email, if you will still allow me to do so. Please advise me of what you think regarding this situation. I appreciate your help so much. I don't think I would have slept last night without your counsel. This is my first baby, so it means a lot to me to have reliable expert advice to get me through this :)
Answered by Dr. Anil Grover 24 minutes later
Thank you for the kind words you have for me Ms. Pleasure is all mine if my line of thinking comforted you in any way. I am glad to hear.

I will agree with you that children bring happiness to our life and specially the first one is almost always eagerly awaited with a touch of anxiety. Let me assure you Ms. whatever, you have disclosed so far, it is absolutely fair to draw the conclusion baby, who is yet to take birth, has a normal heart.

Let us wait for your next ultrasound. Sure enough you can share the reports with
My personal email address is YYYY@YYYY . Thanks.


(Dr Anil Grover)

Above answer was peer-reviewed by
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