Combined ventricular shortening fraction: An echocardiographic index of fetal systolic cardiac function

Fetal cardiac function was investigated using a two-dimensional directed M-mode measurement of combined ventricular shortening fraction (SF). From a four-chamber view, the M-line was directed perpendicular to the atrioventricular valves to obtain end-diastolic and systolic dimensions from RV anterior wall to LV posterior wall in 76 normal gestations (NL), 29 well-controlled diabetics (DM), and two hydropic fetuses with ventricular dysfunction. SF was inversely proportional to gestational age and heart size, but independent of heart rate and umbilical artery Doppler wave form (A/B). In NL, SF = 43 ± 5% (range 33-55) and was not significantly different from that in DM (SF = 43 ± 6% range 30-56), even in the presence of abnormal A/B. Both fetuses who died in hydrops had decreased SF of 15 and 23% SF is a practical tool to assess fetal systolic function and response to therapy.