Antenatal Testing

Highlights: Fetal Echocardiogram Ordering and Indications - Meriter Hospital

Scheduling & Timing

1. There is a separate order in the Unity Point System for fetal echoes that helps the order standout to other tests that are ordered in the perinatal clinic and helps the order get to the specific schedulers that work on fetal echo scheduling in both the Meriter and UW system

   1. NUR3027 - SCHEDULE FETAL ECHOCARDIOGRAM AT PRENATAL DIAGNOSTICS AT MHM

2. Presumed normal fetal echoes (e.g., IVF, family history, etc.) are currently being scheduled 3–6 weeks out.

   1. These orders can be placed early in pregnancy, along with other orders that are placed for the duration of the pregnancy

3. We aim to schedule fetal echos after the 20-week anatomy scan, in case additional indications arise at that time (Unless an early indication is indicated)

Family History Clarification

1. Under fetal indications, “family history” refers to first-degree relatives of the fetus—mother, father, or sibling of the fetus

   1. One exception would be a family history of left heart lesions or bicuspid aortic valve, this can be ordered if there is a history in second degree relatives as well as it can skip a generation

2. If there is a strong family history beyond first-degree relatives that you feel warrants a fetal echo, please feel free to order one.

Diabetes & A1C Guidelines

1. Patients with Pregestational diabetes should receive a fetal echo if:

   1. Preconception A1C > 6.5

   2. A1C > 8: Recommend a 16-week fetal echo

2. These orders can also be placed early to ensure optimal scheduling within the pregnancy timeline.

Clinic Locations & Epic Notes

1. Fetal echo clinics are held at both Meriter and UW Health Kids, staffed by the same group of physicians.

2. If you don’t see fetal echo results under Imaging in Epic, check:

   1. Care Everywhere

   2. UW Health Epic (results now appear under the Cardiology tab, not Imaging)