This document is endorsed by the Fetal Heart Society, the Society of Pediatric Echocardiography, and the American Institute of Ultrasound in Medicine.

In 2004 the American Society of Echocardiography (ASE) guidelines and standards for the performance of fetal echocardiography were published.1 The writing group, commissioned by the Pediatric Council of the ASE, provided a review of the medical literature as well as a summary of expert consensus to create a document that was much needed and served the fetal and pediatric echocardiography community for almost two decades. However, the field continues to advance rapidly, and since the time of that publication, a great deal of new information has become available.

Over the past 5 years, several professional groups, including the American Heart Association (AHA),2 the International Society of Ultrasound in Obstetrics and Gynecology,3 and the American Institute of Ultrasound in Medicine (AIUM),4 have published updated guidelines and standards documents on fetal cardiac evaluation. Since the publication of the ASE’s document in 2004, much of what has been learned is due to an intense desire for multidisciplinary collaboration, pooling multicenter data and expertise from subspecialists including pediatric cardiologists, radiologists, obstetricians, maternal fetal medicine specialists, and sonography practitioners, all important stakeholders in the care of fetal patients with cardiovascular disease. Ongoing research and collaboration have supported efforts toward a better understanding of fetal physiology and disease processes and progression. This has led to significant improvements in fetal imaging and in clinical practice and outcomes for patients.

Given that the future of fetal cardiology includes multidisciplinary cooperation,5 there is new information available that should be summarized and relayed in a revised ASE statement to maintain the best practice for fetal echocardiography and fetal and perinatal cardiovascular care across disciplines. The purpose of this document is to provide updated recommendations for the performance and interpretation of fetal echocardiography in the detection, classification, risk assessment, and perinatal care planning of the pregnancy in which the fetus has cardiovascular disease. This document replaces the 2004 ASE guideline mentioned earlier.