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When to refer a patient to the Maternal Fetal Care Center for FCI evaluation

Please refer to us early for fetuses with any signs of aortic stenosis. Not all fetuses with aortic stenosis will progress to HLHS, but even mild aortic stenosis in midgestation can progress rapidly within a few weeks!

Fetal echo findings that predict natural history progression to HLHS:

  1. retrograde flow in the transverse aortic arch
  2. left to right flow at PFO, which is reversal of the normal fetal flow pattern
  3. fused or monophasic mitral valve inflow Doppler
  4. moderate to severe left ventricular dysfunction

How to refer a patient

  1. Please send a request with your patient's name and medical records from current pregnancy. Records should include fetal echo reports, ultrasound and MRI reports, genetic testing results, demographics, and insurance information.
  2. Send DICOM echo imaging to https://bch.ambrahealth.com/share/bostonchildrenshospital.
    • If this is your first time accessing Ambra, you will need to create an account. You will have access to the studies you upload going forward.
    • If you already have Ambra, our share code is BostonChildrensHospital (all one word).
    • Please email MFCCReferrals@childrens.harvard.edu and cc our Cardiology Image Service Center at CISC@childrens.harvard.edu once the studies have been uploaded so the images can be processed and reviewed as quickly as possible. This same link can be used to send images to Boston Children’s Cardiology going forward. Please email CISC@childrens.harvard.edu each time you send images.
    • If you have imaging and documentation that are in a non-DICOM format (AVI, MP4, MOV, PDF, etc.), please use https://access.ambrahealth.com/share/nondicomupload.
  3. On sending images electronically:
    • Please request a link to Life Image from a member of our team by emailing fetalcardio@cardio.chboston.org. Please only open the link when you are ready to upload. Links lasts for 30 days; if you attempt to use it and do not make an upload, a new link will have to be sent. Please upload ultrasound/MRI images to Life Image in DICOM format. Let a member of our team know when you have uploaded or sent the images so we can review them as quickly as possible.
  4. To mail images, please send a disc to:
    • Maternal Fetal Care Center
      c/o Boston Children’s Hospital
      300 Longwood Ave. / Pavilion 2
      Boston, MA 02115