{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T16:11:29Z","timestamp":1777997489197,"version":"3.51.4"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007797","name":"University of Helsinki","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007797","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Limited data exist on the implementation of current fetal cardiology training and practice guidelines, how trainees are assessed, and how trained fetal cardiologists maintain their skills among countries affiliated with the Association of European Paediatric and Congenital Cardiology (AEPC). A structured questionnaire was sent to fetal cardiologists or national delegates from 44 centers in 33 European countries. Responses were obtained from 37 centers in 29 European countries with 31 responses from fetal cardiologists. Fetal echocardiography was equally performed in maternal (18) and pediatric (16) hospitals with median 3 (range 0\u20136) fetal cardiologists per center and\u2009&gt;\u20094 fetal cardiologists in 13 centers. Core and advanced fetal cardiology training was offered in 17 (46%) and 21 (57%) centers. Advanced training was provided in higher volume centers (19\/21). Assessment methods included direct trainee observation, case-based discussions, and participation in multidisciplinary team meetings, with mostly verbal feedback provided. Criteria for independent fetal echocardiography and counseling were based on training duration (range 2\u201324\u00a0months), number of assessments (range 100\u20131500), and number of counseling abnormal cases (range 40\u2013200) performed under expert supervision, as well as on expert evaluations of trainees based on direct observation and fetal cardiac diagnostic accuracy. Formal certification in fetal cardiology was reported in three centers. Research activity among trained experts was reported among 25 (68%) respondents overall with 19 respondents involved with collaborative research. Trainee research was encouraged but not mandatory in clinical training. Maintenance of expert skills included sufficient clinical activity volume, teaching, and different forms of national and international networking. Fetal cardiology service quality assessments included missed cases discussion in 20 (54%) centers. There is substantial variation in advanced fetal cardiology training practice in Europe suggesting a need for further clarification of training criteria and structure. Trainee assessment is mainly verbal and based on direct observation. There seems to be a need to strengthen the fetal cardiology module in core pediatric cardiology training and to improve quality assessment of the clinical service provided.<\/jats:p>","DOI":"10.1007\/s00246-025-04006-0","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T16:43:45Z","timestamp":1756745025000},"page":"2138-2146","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Current Status of Fetal Echocardiography Imaging and Fetal Counseling Fellow Training in 29 European Countries"],"prefix":"10.1007","volume":"47","author":[{"given":"Taisto","family":"Sarkola","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna N.","family":"Seale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Tulzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie M.","family":"Duignan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Grzyb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Tuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Vanhie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin J.","family":"McMahon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Fetal Cardiology Working Group of the AEPC","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misha","family":"Bhat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damien","family":"Bonnet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally-Ann","family":"Clur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria C.","family":"Escobar-Diaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katya","family":"De Groote","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Senka","family":"Dinarevic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte Duhn","family":"Kruse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana","family":"Dumitrascu-Biris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone Goa","family":"Diab","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Herberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonis","family":"Jossif","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Kavga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anik\u00f3","family":"Lad\u00e1nyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inguna","family":"Lubaua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"McMahon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaros\u0142aw","family":"Meyer-Szary","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joana O.","family":"Miranda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Olejnik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gylfi","family":"\u00d3skarsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vojislav","family":"Parezanovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Seale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lila","family":"Seidl-Mlczoch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Skaiste","family":"Sendzikaite","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Steinhard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva-Liina","family":"S\u00fc\u00fcden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viktor","family":"Tomek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald","family":"Tulzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Turi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aphrodite","family":"Tzifa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zornitsa","family":"Vassileva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Weber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"issue":"7","key":"4006_CR1","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/j.echo.2023.04.014","volume":"36","author":"AJ Moon-Grady","year":"2023","unstructured":"Moon-Grady AJ, Donofrio MT, Gelehrter S, Hornberger L, Kreeger J, Lee W et al (2023) Guidelines and recommendations for performance of the fetal echocardiogram: an update from the American Society of Echocardiography. J Am Soc Echocardiogr 36(7):679\u2013723. https:\/\/doi.org\/10.1016\/j.echo.2023.04.014","journal-title":"J Am Soc Echocardiogr"},{"issue":"6","key":"4006_CR2","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1002\/uog.26224","volume":"61","author":"JS Carvalho","year":"2023","unstructured":"Carvalho JS, Axt-Fliedner R, Chaoui R, Copel JA, Cuneo BF, Goff D et al (2023) ISUOG practice guidelines (updated): fetal cardiac screening. Ultrasound Obstet Gynecol 61(6):788\u2013803. https:\/\/doi.org\/10.1002\/uog.26224","journal-title":"Ultrasound Obstet Gynecol"},{"key":"4006_CR3","doi-asserted-by":"publisher","unstructured":"Donofrio MT, Moon-Grady AJ, Hornberger LK, Copel JA, Sklansky MS, Abuhamad A, American Heart Association Adults With Congenital Heart Disease Joint Committee of the Council on Cardiovascular Disease in the Young and Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and Council on Cardiovascular and Stroke Nursing et al (2014) Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation 129(21):2183\u20132242. https:\/\/doi.org\/10.1161\/01.cir.0000437597.44550.5d","DOI":"10.1161\/01.cir.0000437597.44550.5d"},{"key":"4006_CR4","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951124025885","author":"JH Dangel","year":"2024","unstructured":"Dangel JH, Clur SA, Sharland G, Herberg U, Fetal Cardiology Working Group of the AEPC (2024) Recommendations for the training and practice of fetal cardiology from the Association of European Paediatric Cardiology. Cardiol Young. https:\/\/doi.org\/10.1017\/S1047951124025885","journal-title":"Cardiol Young"},{"key":"4006_CR5","unstructured":"Jowett V, British Congenital Cardiac Association (BCCA) Fetal Cardiology Standards Working Group et al (2021) British congenital cardiac association fetal cardiology standards. https:\/\/static1.squarespace.com\/static\/66d1910d8e37ae3c9a83dc3a\/t\/67093da91db16875f25c62a1\/1728658858590\/BCCA_STANDARDS_FETAL_CARDIOLOGY_Sept_2021.pdf"},{"issue":"11","key":"4006_CR6","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.1017\/S1047951120003455","volume":"30","author":"R Heying","year":"2020","unstructured":"Heying R, Albert DC, Voges I, Sendzikaite S, Sarquella-Brugada G, Pluchinotta F (2020) Association for European Paediatric and Congenital Cardiology recommendations for basic training in paediatric and congenital cardiology 2020. Cardiol Young 30(11):1572\u20131587. https:\/\/doi.org\/10.1017\/S1047951120003455","journal-title":"Cardiol Young"},{"issue":"6","key":"4006_CR7","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1016\/j.jacc.2015.03.010","volume":"66","author":"S Srivastava","year":"2015","unstructured":"Srivastava S, Printz BF, Geva T, Shirali GS, Weinberg PM, Wong PC et al (2015) Task force 2: pediatric cardiology fellowship training in noninvasive cardiac imaging. J Am Coll Cardiol 66(6):687\u2013698. https:\/\/doi.org\/10.1016\/j.jacc.2015.03.010","journal-title":"J Am Coll Cardiol"},{"key":"4006_CR8","unstructured":"Joint Royal Colleges of Phycisians Training Board (JRCPTB) (2021) Curriculum for pediatric cardiology training. https:\/\/www.thefederation.uk\/sites\/default\/files\/Paediatric%20Cardiology%202021%20Curriculum%20FINAL.pdf"},{"issue":"11","key":"4006_CR9","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1016\/j.echo.2015.07.005","volume":"28","author":"MT Donofrio","year":"2015","unstructured":"Donofrio MT, Skurow-Todd K, Berger JT, McCarter R, Fulgium A, Krishnan A et al (2015) Risk-stratified postnatal care of newborns with congenital heart disease determined by fetal echocardiography. J Am Soc Echocardiogr 28(11):1339\u20131349. https:\/\/doi.org\/10.1016\/j.echo.2015.07.005","journal-title":"J Am Soc Echocardiogr"},{"issue":"3","key":"4006_CR10","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1017\/S1047951123003098","volume":"34","author":"CJ McMahon","year":"2024","unstructured":"McMahon CJ, Milanesi O, Pitk\u00e4nen-Argillander O, Albert-Brotons DC, Michel-Behnke I, Voges I et al (2024) Assessment for learning of paediatric cardiology trainees in 41 centres from 19 European countries. Cardiol Young 34(3):588\u2013596. https:\/\/doi.org\/10.1017\/S1047951123003098","journal-title":"Cardiol Young"},{"issue":"6","key":"4006_CR11","doi-asserted-by":"publisher","first-page":"2505","DOI":"10.1007\/s00404-023-07133-2","volume":"309","author":"P Janzing","year":"2024","unstructured":"Janzing P, Nourkami-Tutdibi N, Tutdibi E, Freundt P, von Ostrowski T, Langer M et al (2024) Controlled prospective study on ultrasound simulation training in fetal echocardiography: FESIM II. Arch Gynecol Obstet 309(6):2505\u20132513. https:\/\/doi.org\/10.1007\/s00404-023-07133-2","journal-title":"Arch Gynecol Obstet"},{"issue":"7","key":"4006_CR12","doi-asserted-by":"publisher","first-page":"1548","DOI":"10.1007\/s00246-022-02882-4","volume":"43","author":"JA Keelan","year":"2022","unstructured":"Keelan JA, Moon Grady AJ, Arya B, Donofrio MT, Schidlow DN, Tacy TA et al (2022) Current state of fetal heart disease counseling and training: room for improvement? endorsed by the Fetal Heart Society. Pediatr Cardiol 43(7):1548\u20131558. https:\/\/doi.org\/10.1007\/s00246-022-02882-4","journal-title":"Pediatr Cardiol"},{"issue":"2","key":"4006_CR13","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9020467","volume":"9","author":"A Kovacevic","year":"2020","unstructured":"Kovacevic A, B\u00e4r S, Starystach S, Simmelbauer A, Els\u00e4sser M, M\u00fcller A et al (2020) Objective assessment of counselling for fetal heart defects: an interdisciplinary multicenter study. J Clin Med 9(2):467. https:\/\/doi.org\/10.3390\/jcm9020467","journal-title":"J Clin Med"},{"issue":"1","key":"4006_CR14","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11010278","volume":"11","author":"A Kovacevic","year":"2022","unstructured":"Kovacevic A, Wacker-Gussmann A, B\u00e4r S, Els\u00e4sser M, Mohammadi Motlagh A, Ostermayer E et al (2022) Parents\u2019 perspectives on counseling for fetal heart disease: what matters most? J Clin Med 11(1):278. https:\/\/doi.org\/10.3390\/jcm11010278","journal-title":"J Clin Med"}],"container-title":["Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-025-04006-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00246-025-04006-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-025-04006-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T15:16:49Z","timestamp":1777994209000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00246-025-04006-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":14,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["4006"],"URL":"https:\/\/doi.org\/10.1007\/s00246-025-04006-0","relation":{},"ISSN":["0172-0643","1432-1971"],"issn-type":[{"value":"0172-0643","type":"print"},{"value":"1432-1971","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,1]]},"assertion":[{"value":"15 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The requirement for a full review by the Children\u2019s Health Ireland Research ethics committee was waived.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}