Introduction Assessment of cardiac function forms an integral part of every fetal cardiac evaluation.1 In the screening echocardiogram, subjective assessment of ventricular contractility in a standard four-chamber view may be sufficient to meet this requirement. Where there is congenital heart disease (CHD), however, detailed assessment of cardiac function is crucial, and in complicated pregnancies such as twin-twin transfusion syndrome (TTTS), twin-reversed arterial perfusion (TRAP), intrauterine growth restriction (IUGR), fetal infection (parvovirus, cytomegalovirus, coxsackievirus, etc.), anemia, lung masses, hydrops, sacrococcygeal teratoma, or placental chorioangiomas, cardiovascular function is an important element in guiding the management of these pregnancies.