Table 1. Recommendations for fetal echocardiography in high-risk pregnancies^5–9 .

Recommendations	Recommendation class	Evidence level
Pre-gestational DM	I	A
GDM diagnosed in first trimester	II	B
Maternal phenylketonuria	I	A
Maternal SSA/SSB antibodies	IIa	B
Maternal medications: ACE inhibitors Retinoic acid NSAID in third trimester	IIa I I	B B A
Maternal rubella infection in first trimester	I	C
Maternal infection with suspicion of myocarditis/pericarditis	I	C
Assisted reproduction	IIa	A
Congenital heart disease in first-degree relative	I	B
Heart disease with Mendelian inheritance in first or second-degree relative	I	C
Suspicion of heart disease on obstetric ultrasound	I	B
Extracardiac fetal anomaly	I	B
Fetus with chromosome abnormality	I	C
Fetus with tachycardia or bradycardia or frequent irregular heartbeats	I	C
NT > 95%	I	A
Monochorionic twinning	I	A
Fetus with hydrops or effusions	I	B

ACE: angiotensin-converting enzyme; DM: diabetes mellitus; GDM: gestational diabetes mellitus; NSAID: nonsteroidal anti-inflammatory drugs; NT: nuchal translucency. Adapted from Donafrio et al.⁷