In routine target scan, we examine the fetal heart using 6 views. In most instances this is adequate enough to exclude serious heart problems in the babies. However, there are instances where a specialised detailed examination of the heart is undertaken. This is known as fetal echocardiography. In fetal echocardiography, the baby’s heart is thoroughly checked for normalcy of structure and function. In addition to the usual way of examination, additionally we use Doppler mode of examination to accurately gauge function of the heart valves, the connections to and from the heart. The Fetal echocardiography, as opposed to newborn echocardiography is designed to exclude life-threatening or serious malformations in the heart. There are a few ‘defects’ that are quite common and yet may not be detected when the baby is inside the uterus. For example, hole in the heart or ventricular septal defect, may not be detected unless its large enough. Similarly, other problems with the heart valves or muscle that develop later in pregnancy may not be detected by fetal echocardiography. In summary, while fetal echocardiography is a good tool to exclude major defects of the fetal heart, there will be times when a newborn echo is required to establish normalcy or otherwise. Generally, fetal echocardiography is best performed between 22 and 24 weeks . Major indications include maternal diabetes, previous child with cardiac problem, mother with cardiac illness or any family history of cardiac defects, any suspicious finding in previous scans.