Abstract： Objective To investigate the significance of ultrasonic soft marker on severe fetal cardiac structural abnormalities during the first trimester. Methods A total of 2972 pregnant women,who underwent ultrasound examination at the first trimester between January 2014 and June 2015 in our hospital, were included in the study. After transabdominal and/or transvaginal ultrasound examination,the soft markers of nuchal translucency(NT)value,tricuspid regurgitation(TR)and venous catheter bloodstream a wave(DV a wave)inversion were recorded. The sensitivity and specificity of all soft markers for the diagnosis of severe cardiac abnormalities were calculated. Results Among 2 972 fetus,42 were diagnosed with cardiac abnormalities,including 31 severe cardiac abnormalities,among whom 23 underwent the first trimester diagnosis. The sensitivity of all abnormal soft markers for the diagnosis of severe cardiac abnormalities was 74.19%(23/31). The NT thickness of 95~99 percentile included 134 fetuses(4.51%,134/2 972). Seven cases were diagnosed prenatally with cardiac abnormalities,including 5 diagnosed at the first trimester,2 diagnosed at the second trimester,the diagnostic sensitivity was 22.58%(7/31),and the specificity was 4.27%(127/2 972). The NT thickness>99th percentile(1.01%,30/2 972)were found in 30 cases. Thirteen cases were diagnosed prenatally with cardiac abnormalities,including 10 first trimester diagnosis,3 second trimester diagnosis,the diagnostic sensitivity was 41.94%(13/31),and the specificity was 0.57%(17/2 972). There were 34 TR(1.14%)and 70 DV a wave inversion(2.35%). In 42 cases diagnosed prenatally with cardiac abnormalities,there were 11 cases with TR,the diagnostic sensitivity of 35.48%(11/31),and the specificity was 0.77%(23/2 972);10 cases with DV a wave inversion,the diagnostic sensitivity was 32.26%(10/31),and the specificity was 2.01%(60/2972). Conclusion NT thickening,TR and DV a wave inversion have clinical significance in severe fetal cardiac abnormalities, which can provide evidence for the clinical diagnosis of congenital heart disease.