Hobbins JC, et al. - Researchers sought to ascertain the number of fetuses with an abnormal size and shape of the 4-chamber view and size of the ventricles in fetuses with an estimated fetal weight < 10^th centile. They studied 50 fetuses between 25 and 37 weeks of gestation with an estimated fetal weight < 10^th centile in this retrospective study. These fetuses exhibited higher rates of abnormalities of cardiac size and shape of the 4-chamber view; this was noted regardless of their umbilical artery pulsatility index and cerebroplacental ratio measurements. Larger and wider measurements of the 4-chamber view were recorder for those with a normal umbilical artery pulsatility index and an abnormal cerebroplacental ratio. In addition, a more globular or round shape of the 4-chamber view was observed in these fetuses relative to controls. The risk of perinatal complications and childhood and/or adult cardiovascular disease may be higher in these fetuses. Screening tools derived from the 4-chamber view, acting as surrogates for ventricular dysfunction, may assist in recognizing fetuses requiring comprehensive testing and future preventive interventions.