To assess the value of fetal echocardiography in the prenatal diagnosis and prognostic evaluation of fetuses with simple foramen ovale channel restriction (FOCR) combined with cardiac dysfunction.

Sixteen fetuses diagnosed as having simple FOCR by prenatal echocardiography and cardiac dysfunction by cardiovascular profile score (CVPS) at Hebei Maternity Hospital from October 2018 to May 2020 were analyzed retrospectively. Their echocardiographic features and changes of cardiac function were dynamically observed to guide timely delivery, and the pregnancy outcome and prognosis were followed.

Among the included fetuses, 14 showed the inner diameter of the foramen ovale or the effective shunt of the foramen ovale channel＜3 mm, and 2 had an inner diameter of the foramen ovale/the total length of the atrial septum＜0.33. Prenatally, the ratios of RA/LA, RV/LV, and MPA/AAO increased with gestational age, and V-FO was＞40 cm/s in all the 16 fetuses. Before delivery, all the 16 fetuses showed decreased CVPS, with 8-9 in 11 fetuses and 6-7 in 5. After delivery, 1 fetus died of acute respiratory distress syndrome in the neonatal period, and the other 15 fetuses survived without intrauterine fetal death. Postpartum reexamination revealed a normal heart in 13 fetuses, suspected cardiomyopathy in 1, and non-excluded primary pulmonary hypertension in 1. The abnormal indexes of CVPS in the 16 fetuses mainly included massive holosystolic tricuspid regurgitation, increased C/T, decreased FS in the left or right ventricle, abnormal spectrum of venous catheter, pericardial effusion, and pleural effusion. The CVPS of nine fetuses before delivery was lower than that at the first visit.

Prenatal echocardiography has important value in the diagnosis and prognostic evaluation of prenatal FOCR. Moreover, prenatal echocardiography can dynamically observe and evaluate the changes in fetal cardiac function, which is of great significance to evaluate intrauterine fetal condition and guide delivery.