Tiny Tickers commissioned to start training in NHS Scotland health boards.

We are delighted to announce the start of our fetal cardiac training program in Scotland.

This will focus on implementing the 3vt (3 vessel trachea) view as part of the cardiac protocol for the fetal anomaly scan. Commissioned by NHS Scotland and working with Healthcare Improvement Scotland, Tiny Tickers will provide training for all antenatal sonographers across the country in the required cardiac views to better detect potential heart defects. 

We know that sonographers are more skilled and confident in detecting cardiac defects following our training. We hope that around 50,000 births in Scotland every year will receive a higher standard of cardiac screening at the 20-week fetal anomaly scan as a result.

One in every 125 babies is born with a heart problem but fewer than half of those are spotted during pregnancy and, in some parts of the UK, detection rates are as low as 1 in 4. That means over 1,000 newborns leave hospitals in the UK every year with no one realising they have a potentially life-threatening heart condition. Babies with undetected heart defects will often fall into the early stages of heart failure – significantly impacting their long-term quality of life. Some will die before anyone realises they have a poorly heart, or before getting the surgery that would save them. We want to increase early detection rates of cardiac conditions thus improving a baby’s chances of survival and long-term quality of life.

Tiny Tickers trained at Raigmore Hospital in Inverness, NHS Highland, in 2018.
Training will start with NHS Grampian & NHS Lanarkshire in mid August and move to other NHS boards over the coming months.


When heart defects are detected during pregnancy, babies get treatment from the first possible moment. Prenatal detection also means that parents-to-be get the support they need to prepare them for the future; it means fewer dangerous and costly emergency admissions to hospital, and fewer cancelled operations because of these admissions. As some areas of Scotland are more geographically remote, babies may be born some distance from the nearest cardiac unit at The Royal Hospital for Children (RHC) in Glasgow. This makes antenatal detection even more important so that preparations for those babies’ births and subsequent treatment can be made.

“We are delighted to have been asked to provide our training programme to all obstetric sonographers performing the routine 20-week anatomy scan in Scotland. We will cover the standard views required at the 20-week anatomy scan, with particular focus on the incorporation of the 3VT view. This particular view aids detection of critical congenital heart defects and can give clues to some cardiac defects that may be more subtle to discern from other views. Sonographer training has been shown to have had a direct impact upon the increase in the antenatal detection of congenital heart disease.”

Anne Rhodes, Head of Training for Tiny Tickers

We believe the biggest single factor in increasing detection rates is sonographer training. So the point of our training services is simple – to give health professionals the confidence, knowledge and skills to better spot heart defects during pregnancy screening. More information about our sonographer training programme can be found here.