Beyond evaluating physiologic alterations encountered during pregnancy quantitative pulsed- and continuous Doppler and qualitative co- lor Doppler technology can be used for cardiovascular assessment of the pregnant woman with heart disease or suspected cardiac ab- normality. Echocardiography provides information about disease etiology, leads to accurate and non- invasive assessment of disease se- verity and is a powerful means of monitoring progression. Only with echocardiography it has been clearly demonstrated that during preg- nancy congenital heart disease is the first leading abnormality followed by rheumatic heart disease. Doppler and qualitative color Dopp- ler are useful to illuminate the pathophysiology of the hemodynamic consequences of fixed valve stenosis during pregnancy with respect to the labile nature of gradients resulting from variable loading conditions of pregnancy. Accurate cardiac diagnosis leads to accurate es- timation of prognosis, illuminates the necessity of noninvasive monitoring throughout pregnancy and labor, and leads to determine whet- her surgical or medical intervention should be performed. Need for Fetal echocardiography should also be considered after maternal ec- hocardiography is undertaken. Although there are no strictly defined limits established for the use of Doppler ultrasound in the early preg- nancy there is an unequivocal demand for carefulness that is best expressed by the ALARA principle,-as low as reasonably achievable.