Abstract: Objective：To evaluate the clinical value of fetal echocardiography on high risk pregnancies of congenital heart disease between 11 and 16 weeks′ gestation. Methods: 668 women with high risk pregnancies underwent fetal echocardiography between 11 and 16 weeks′ gestation in Tianjin central hospital of Gynecology and Obstetrics and Division of Cardiology, the Children′s Hospital of Philadelphia. Among them , 404 cases were screened with four-chamber view scanning methods and 264 cases with sequential segmental scanning methods. Results: Among all the high-risk pregnancies, the detection rate of complicated congenital heart diseases was 5.7%（23/404） by fetal echocardiography four-chamber view scanning methods and 9.5%（25/264） by sequential segmental scanning methods, there was no statistical difference （P＞0.05）. The detection rate of complicated congenital heart diseases in increased NT and cystic lymphangioma pregnancies was 2.5% （9/362） by fetal echocardiography four-chamber view scanning methods and 10.0%（7/70） by sequential segmental scanning methods, with was statistical difference（P＜0.05）. The detection rate of complicated congenital heart diseases between 12 weeks′ and 14 weeks′ by the two scanning methods were 5.9%（21/358） and 10.4%（8/77）, respectively, with no statistical difference （P＞0.05）。Conclusions: As more and more high risk factors, such as increased NT, cystic lymphangioma and fetal non-cardiac malformation, were found in early pregnancy, it was necessary to screen the fetal heart malformation at the same time. Four-chamber view was the most important and easily available section in fetal echocardiography, especially in the early stages. Four-chamber view scanning methods had a high practical and clinical application value for the detection of severe congenital heart disease. Early detection of severe congenital heart disease can reduce the damage to pregnant women themselves.

Key words: Heart defects, congenital, Ultrasonography, Pregnancy trimester, first, Pregnancy trimester, second, Pregnancy, high risk, Screening