Fetal Cardiac Program
The Fetal Cardiac Program provides diagnosis, counseling, and treatment for potential heart problems in the developing baby during pregnancy. The program is part of the Labatt Family Heart Centre at SickKids and is made up of a multidisciplinary team. Our program offers timely evaluations when a heart abnormality is suspected, in addition to first trimester (12-14 weeks) and second trimester (18-20 weeks) screening examinations for at-risk pregnancies. We work closely with diagnostic imaging and pregnant care providers throughout Ontario, as well as geneticists and other expert fetal and pediatric subspecialists where necessary. Our collaboration with the Ontario Fetal Centre enables us to offer a range of potential fetal cardiac therapeutic and interventional strategies.
As the gateway to Ontario’s only centre for neonatal cardiac surgery, we proudly serve as the fetal cardiac referral centre for the province. We also offer out-of-province and out-of-country consultations. Our dedicated team of specialized fetal and paediatric cardiologists within the Division of Cardiology, sonographers, nurses, and social workers, amongst others, ensures that families receive the highest quality of care possible from pregnancy, through their journey at SickKids, and beyond.
The program also serves as a world-renowned academic centre for fetal cardiology, affiliated with the University of Toronto. We host regular regional, national, and international conferences.
For providers
For a suspected cardiac anomaly, including congenital heart disease, arrhythmia, or impaired cardiac function, we will see at any time during the pregnancy. Given the time-sensitive nature of prenatal diagnosis, we aim to see within 1 week of referral.
Please refer as soon as a cardiac abnormality is suspected or if the fetal heart is not well seen on ultrasound.
In addition, we offer first and second trimester screening examinations for specific indications, such as first degree family history/prior baby with congenital heart disease, increased nuchal thickness, suspected extracardiac anomaly or genetic condition, mono-mono and mono-di pregnancies, and maternal conditions or exposures (i.e., diabetes mellitus, PKU, exposure to retinoids, ACE inhibitors, paroxetine (SSRI), etc.).
Ideal timing of screening fetal echocardiogram:
- First trimester: 12-14 weeks
- Second trimester: 18-20 weeks
How to make a referral
Online referrals are encouraged (one-time set-up required): Referring a patient to SickKids using the online referral system
For urgent referrals, or if online access is not available to you, please email us at fetal.cardiology@sickkids.ca or contact us at 416-813-4914 for a copy of a requisition form for a fetal echocardiogram.
Urgent referrals are seen within days. Other referrals are typically scheduled within 1-2 weeks.
For further questions about the referral process or if you did not receive a copy of your patient’s report, please contact us at 416-813-4914. If you would like to contact the providers who saw your patient, you may also contact the team members directly.
For patients
Learn more about the Fetal Cardiac Program clinic, what to expect during a visit, how to prepare and more on our Clinic page.
For additional information, please read the Fetal Cardiology Pamphlet (PDF).
Section Head, Fetal Cardiology, Fetal and Paediatric Cardiologist
Vitor Guerra
Fetal and Paediatric Cardiologist
Koyelle Papneja
Fetal and Paediatric Cardiologist
Division Head, Paediatric Cardiology, Fetal and Paediatric Cardiologist and Radiologist
Clinical Nurse Coordinators
nathalie.dutil@sickkids.ca
zoey.katz@sickkids.ca
lisa.stennett@sickkids.ca
- Nick Arbic
- Michelle Eden
- Shabia Khalid
- Robert Khan
- Yue Yi (Elsie) Wen
Fellows are medical physicians who are paediatric cardiologists or obstetricians and are undertaking advanced training in fetal cardiology.
- Mayola Mathew
- Heather Telfer
- Edna Parmer
- Shelby Avelar
- Karina Subhanie
- Danielle Squires
Research
Research is one of the foundations of the Fetal Cardiac Program. Many of the advances in imaging and care for babies with heart problems during pregnancy have come from research at SickKids.
During your visit, you may be approached regarding participation in a research project. Participation in research is voluntary and will not affect the care you and your baby receive at SickKids.
Examples of active areas of research include:
- Fetal cardiac therapy and interventions for congenital heart disease
- Management of fetal arrhythmias, including those associated with maternal antibodies
- Lifelong follow-up of prenatally diagnosed congenital heart disease, with a focus on Ebstein anomaly and single ventricle defects
- Impact of the developing baby’s heart on the developing brain
- Intersection of genetic findings and fetal cardiac outcomes
Education and Outreach
Education and outreach are pillars of the Fetal Cardiac Program at SickKids. We believe it is our mission to improve health care for pregnant women across the province and to educate the next generation of leaders.
We offer a one-year fetal cardiology fellowship for advanced pediatric cardiology or maternal-fetal medicine trainees. The annual deadline to apply is March 31, for a start date of July 1 the following academic year (15 months after the application deadline). Please visit the Subspecialty Fellowship page for more information and to apply.
This fellowship is generously funded by the Policaro Foundation. Learn more by watching this video: Q&A with Dr. Freud.
The following opportunities are available for anyone involved in the prenatal diagnosis and management of pregnancies affected with or at risk of fetal cardiac conditions, such as sonographers, nurses, community partners in pregnancy care (midwives, radiologists, obstetricians), community and academic high-risk obstetricians and pediatric/fetal cardiologists, and geneticists/genetic counselors, amongst others:
- Weekly Fetal Cardiology Rounds are hosted by SickKids on Zoom. Sessions are eligible for CME/MOC credits and CPD/CME/ARDMS for physicians and sonographers, respectively. To be added to this program, contact fetalcardiac.education@sickkids.ca
- SickKids co-hosts quarterly Pan-Canadian Fetal Cardiology Rounds with partners across the country. To be added to this program, contact fetalcardiac.education@sickkids.ca
- In the fall, we host our Annual Fetal Cardiology Symposium. We alternate between offering a 1-day basic course for new learners to fetal echocardiography and offering a more advanced 2–3-day course, featuring both renowned SickKids and international faculty. Both courses are submitted to the Canadian Paediatric Society for CME/MOC credits and Sonography Canada for CPD/CME/ARDMS credits. For more information about the upcoming course, go to www.torontofetalcardiaccourse.com or contact us at fetalcardiac.education@sickkids.ca.
Finally, we are excited to have launched hands-on teaching by our skilled fetal cardiac sonographers. As part of this outreach effort, our sonographers will come to your site! The goal is that, together, we can improve prenatal detection of congenital heart disease. Contact our lead fetal education sonographer, Elsie Wen at yueyi.wen@sickkids.ca, for more information and to set up your first visit.
Contact Us
- Online referrals are encouraged: refer a patient to SickKids using the online referral system
- For urgent referrals, or if online access is not available to you, please email us at fetal.cardiology@sickkids.ca or contact us at 416-813-4914.
- For other clinical questions, please contact one of our nursing staff at 416-813-6514.
- For non-clinical questions (i.e., related to research, education), please contact Lindsay Freud at lindsay.freud@sickkids.ca.