ABSTRACT
The task of the heart both before and after birth is to sustain the circulation to the peripheral tissue by developing pressure, ejecting and receiving blood. As is true after birth, heart failure in the fetus occurs when there is inadequate tissue perfusion. It may be caused by primary cardiac pathologies, but may also evolve secondary to extracardiac pathologies that influence myocardial function and output through increased workload or reduced atrial and ventricular filling. Congestive heart failure (CHF) in utero is manifested as right heart failure with the development of pericardial and pleural effusions, ascites and peripheral, including
placental, edema (Fig. 1). Our understanding of fetal heart failure has largely been derived from early fetal animal models and, more recently, noninvasive observations made at fetal echocardiography.
