How is fetal right ventricular function most accurately assessed?

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Assessing fetal right ventricular function relies on functional information, not just anatomy. The strongest approach combines multiple functional indicators: look at the RV’s size and wall motion to spot dilation or hypokinesia, use Doppler to examine the right ventricular outflow tract flow for real-time systolic performance and flow dynamics, and, when feasible, calculate the myocardial (Tei) index to obtain a single overall measure of both systolic and diastolic performance. This trio gives a comprehensive view of how well the RV is pumping and relaxing in the fetal circulation.

Visualization of the left ventricle alone doesn’t tell you much about the right ventricle’s function and can miss RV-specific issues. Fetal MRI can image structures but isn’t routine for functional assessment due to practical limitations and lower temporal resolution. The amniotic fluid index reflects fetal well-being more broadly and does not directly indicate cardiac function.