Functional assessment of the evolution of congenital heart disease in utero

Purpose of review This article reviews recent developments in the assessment of changes in structure and function in the fetal heart with the focus on congenital heart disease malformations. Recent findings Use of the combination of the cardiovascular profile score, the biophysical profile score and additional physiological measurements with Doppler echocardiography have allowed better characterization of disease states and the changes that can occur in utero during the last two trimesters of gestation. Summary A comprehensive examination of the structure and function of the fetal heart together with the evaluation of other parameters of fetal wellbeing are necessary for comprehensive assessment of the evolution of congenital heart disease in utero. Only such an objective surveillance can elucidate the pathophysiology and natural history, guide appropriate timing of intervention, monitor the success of any in-utero therapy, and predict perinatal outcome.