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Objective: To determine accuracy of diagnosis and outcome of primary cardiac tumors PCT diagnosed by fetal echocardiography FEMethod: We retrospectively evaluated 1960 consecutive FE performed during March 1990-December 2010 followed by chart review of mothers and newborns with PCT at a tertiary care facilityResults: PCT were diagnosed in 19 Patients [0.1%] referred by obstetrics because of cardiac mass in 17 and 2 with large isolated pericardial effusion (PE). The gestational age at referral was 25-34 weeks.15 patients had rhabdomyoma (RM),2 patients had fibromas,11 had Tuberous Sclerosis (TS) including all patients with multiple masses.1 patient with single RM underwent palliation with Blalock-Taussig shunt for right ventricular inflow obstruction with subsequent regression. 1 patient with multiple RM died 12 days postnatally due to ventricular arrhythmias in addition to right ventricular outflow obstruction. The 2 Patients with PE had single right atrial mass; one fetus died in utero due to congenital anomalies and the other underwent successful resection postnatally preceeded by antenatal and postnatal pericardiocentesis.Conclusions: 1.Fetal echocardiography is accurate in assessment of PCT2.PCT should be suspected in fetuses with large isolated PE.3.The most common fetal PCT is multiple RM which is associated with TS.4.PCT can lead to fatal arrhythmias and critical cardiac obstruction.