[Heart failure in utero: diagnosis and therapy]

Over the past 15 years considerable advances in ultrasonography have made increasingly detailed evaluation of the human foetal heart feasible. Accordingly, the presence of cardiac failure can now be diagnosed in human foetuses during the last two thirds of pregnancy by foetal echocardiography. The underlying causes of foetal cardiac failure can be identified and prenatal treatment, if considered appropriate, can be monitored by ultrasonographic methods. Two-dimensional and M-mode echocardiography, as well as Doppler ultrasound, are equally important with respect to evaluation of foetal cardiac failure. Foetal echocardiography has contributed remarkably to broadening our understanding of the conditions and natural course of cardiac failure during prenatal life. In turn, this has led to an increasing readiness to consider new forms of prenatal treatment for foetal cardiac failure.