The Fetal Cardiology Program at the Children's Healthcare of Atlanta Heart Center provides complete consultation services for expectant mothers whose unborn children have suspected or known heart problems.

Led by Erik Michelfelder, MD, a Pediatric Cardiologist at Children’s, the Fetal Cardiology Program is dedicated to providing exemplary care to the fetus diagnosed with structural or functional heart disease, as well as supporting the fetus and expectant family in a compassionate, comprehensive manner.

In 2021, our team treated more than 2,100 patients and performed more than 2,300 fetal echocardiograms, making our program one of the largest fetal cardiology programs in the country. With 13 offices across Georgia, we provide convenient access to families needing fetal cardiac care throughout the state. We have over 20 fetal cardiologists on staff with an average of more than 14 years experience in fetal cardiology. Our extensive experience in cardiac imaging allows each family to receive a comprehensive, specialized fetal cardiac evaluation, including a detailed plan and recommendations for future care to both the referring physician and family.

What can I expect from the Children’s Fetal Cardiology Program?

Once diagnosed, fetal heart problems are managed through an interdisciplinary approach within the Fetal Cardiology Program. Parents consult with cardiologists, cardiothoracic surgeons and cardiac interventionists as indicated for specific heart conditions. We collaborate closely with local and regional obstetricians, maternal-fetal medicine specialists, neonatologists and delivery centers to help make sure care planning and management of the fetus with heart disease is provided at the highest level. We also offer prenatal genetic counseling, social work support and interaction with specialized cardiac nurses.

Our team provides:

  • Family-centered care.
  • Resources for counseling and educating families.
  • Detailed information to help families understand the diagnosis.
  • Assistance in birth planning and post-natal management of the newborn.

Conditions we treat include:

To learn more about our Fetal Cardiology Program, contact Kendall Haney, Clinical Nurse Coordinator, at 404-785-8745.

You may be referred to a fetal cardiologist for a fetal echocardiogram if:

  • An ultrasound or anatomy scan shows a possible heart defect or problem in the baby.
  • The mother, father or siblings of the baby have a history of heart problems.
  • An abnormal or irregular heartbeat is heard in the baby.
  • A genetic or chromosomal abnormality is identified in the baby.
  • Abnormalities in the baby's other major organ systems, such as the brain, kidneys or lungs, are identified by ultrasound.
  • The mother has a medical condition, such as diabetes or phenylketonuria (PKU), or a connective tissue disease, such as lupus or Sjogren's syndrome that can affect the baby's heart.
  • The mother has been exposed to viruses, or certain medicines or drugs that can affect development of the baby's heart.

Frequently Asked Questions About Fetal Cardiology

A fetal echocardiogram (echo) is an ultrasound similar to the one an expectant mother will get at her obstetrician's office. A fetal echo uses sound waves to show your baby's heart in detail. The heart's structure is best seen between 18 and 22 weeks of pregnancy. A fetal echo takes approximately 40 to 60 minutes to complete, depending on the complexity of your baby's heart problem.

A fetal echo will:

  • Check your baby’s heart structure, rhythm and function.
  • Help the medical provider identify and monitor a heart problem.
  • Check to make sure your baby is growing and developing well.

If testing shows your baby has a heart defect, we will work with the maternal-fetal medicine specialist, a high-risk obstetrician, to develop a follow-up schedule to monitor your baby. We will help you understand your baby's condition and needs so that you can make informed decisions for your family and baby.

If your baby's heart condition requires surgery after delivery, we can help prepare you ahead of time by connecting you with a pediatric cardiothoracic surgeon and providing helpful resources.

Learning that your baby has a heart defect can be scary and difficult to comprehend. We have collaborated with other institutions and the Pediatric Congenital Heart Association to create a guided questions tool so that you know the right questions to ask your physician about your baby.

Our team will work closely with your obstetrician and maternal-fetal medicine specialist to determine the best delivery plan for your baby. If a certain hospital location or mode of delivery is indicated, we will work with your family to help this process go as smoothly as possible. Based on your prenatal imaging, our fetal cardiologists will make recommendations regarding the timing of cardiology evaluation and care of the baby's heart condition after delivery. This recommendation is communicated to your obstetrician, specialist and delivery center.

If your baby requires heart surgery, we have the capability to care for him in the Children's Cardiac Intensive Care Unit (CICU). We have one of the largest dedicated CICUs in the country with 32 total beds, in addition to 35 beds in our Cardiac Acute Care Unit (CACU). Once your baby is medically stable, he will be moved from the CICU to the CACU, where our specially trained cardiac nurses and cardiology team will provide care. Parents are strongly encouraged to stay overnight in their child's CACU room. During this time, you can provide emotional support to your child while also receiving the training required to safely care for your child at home. If there are times when you can't stay with your child, parents can call the CACU to speak with their child's nurse and get a medical update.

Each patient's discharge needs, such as nutrition, respiratory care, physical therapy and medication therapy, are assessed. A plan for addressing these needs will be created by the attending physician with input from the Children's interdisciplinary team, which includes a registered nurse, social workers, case managers, therapists, dietitians, child life specialists and other caregivers. Prior to discharge, we will make sure you have educational materials, teaching tools and phone numbers to call if you have questions or concerns about your child's health.

Before your child goes home, parents are required to attend the following classes:

  • CPR class
  • Car seat class (if your child is a newborn)
  • Cardiac surgery discharge class

All classes are free to parents and caregivers. We require that at least one parent take each class if your child has had heart surgery. The car seat class is required if your child is a newborn and has never been home. You must bring your child's car seat and base for inspection.

What is early gestation fetal cardiac imaging?

Fetal echocardiography is a highly sensitive ultrasound test that provides high-quality, accurate images of a baby's heart. Typically, doctors will perform this test to assess the fetal cardiovascular system when a baby is at 18-24 weeks gestation, often in relation to the mother's 20-week ultrasound. However, due to significant advances in ultrasound technology that allows visualization of very small cardiac structures, this test may be done earlier in the pregnancy—as soon as 13-14 weeks gestation. The results of this test provide doctors with information about the heart anatomy and function that allows them to counsel families with pregnancies complicated by a fetal cardiac abnormality.

Why is early gestation fetal cardiac imaging important?

Early testing, such as maternal blood screening for fetal DNA or nuchal translucency screening, can now identify pregnancies at risk for chromosomal anomalies and/ or structural heart disease very early in the pregnancy. Echocardiography helps confirm a diagnosis, so families can know as early as possible if their baby has a cardiac abnormality.

Situations in which early gestation fetal cardiac imaging may be recommended include:

  • Increased nuchal translucency
  • Suspected genetic or chromosomal abnormality
  • History of a prior pregnancy affected by congenital heart disease
  • First degree relative with congenital heart disease

About our Heart Center's early gestation fetal cardiac imaging program

Our Fetal Cardiology Program now has the equipment and operator expertise to assess the fetal heart as early as 13-14 weeks gestation. We can provide families with reliable diagnosis of fetal cardiac abnormality in those high-risk pregnancies where early diagnosis is desired. Because early fetal cardiac imaging is a novel technology, we do recommend in most cases that mothers undergoing early fetal echocardiography have a repeat study at 18-20 weeks gestation to confirm the initial findings.

Thriving today thanks to fetal cardiology care

At their 20-week ultrasound, Miller’s parents learned that their daughter was diagnosed with a rare, complex heart defect. Today, Miller is thriving thanks to the comprehensive, collaborative care that she received through the Children’s Heart Center’s fetal cardiology program.

Read Miller's Story

Our Fetal Cardiology Program team, as well as the Children’s Heart Center team of cardiologists and cardiothoracic surgeons who support the program, are dedicated to the health and well-being of children born with a heart defect. 

  • Erik Michelfelder, MDDirector
  • Kendall Haney, BSN, RN, Clinical Nurse Coordinator
  • Laura Lei Castillo, BSN, RN, CPN, Clinical Nurse
  • Joe Kreeger, RDCS, Lead Fetal Sonographer
  • Erin Demo, MS, CGC, Genetic Counselor
  • Linda Knight, MSc, Genetic Counselor


Cardiothoracic surgeons

This content is general information and is not specific medical advice. Always consult with a doctor or healthcare provider if you have any questions or concerns about the health of a child. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away. Some physicians and affiliated healthcare professionals on the Children’s Healthcare of Atlanta team are independent providers and are not our employees.