Abstract: Objective To evaluate the diagnostic value of fetal cardiac axis angle and venous catheter(DV) spectrum for congenital heart disease in early pregnancy.Methods A total of 616 pregnant women in early pregnancy from June 2019 to June 2022 were selected and their clinical data were retrospectively analyzed. The pregnant women were divided into two groups: an observation group, including 19 pregnant women with fetuses diagnosed with congenital heart disease in early pregnancy, and a control group, including 597 pregnant women with healthy fetuses in early pregnancy. Both groups were compared for the fetal cardiac axis angle, venous catheter spectrum parameters, such as ventricular peak systolic flow velocity(PSV), ventricular peak diastolic flow velocity(PDV), and atrial PSV. The clinical value of each index alone and in combination for the diagnosis of congenital heart disease was evaluated.Results Compared with the control group, the observation group showed remarkable increases in ventricular PSV, ventricular PDV, atrial PSV, and cardiac axis angle(P<0.05). There were 19 positive cases and 597 negative cases among 616 patients.(1)There were 31 cases of venous catheter spectrum abnormalities, and 14 cases were finally diagnosed as congenital heart disease, including 2 cases of atrial septal defect, 5 cases of simple ventricular septal defect, 2 cases of simple atrial septal defect, 1 case of tetralogy of Fallot, 1 case of transposition of the great arteries, 2 cases of right aortic arch, and 1 case of right ventricular double outlet.(2)Cardiac axis angle: there were 7 cases with left axis deviation and 3 cases with right axis deviation, and 7 cases were finally diagnosed as congenital heart disease, including 3 cases of ventricular septal defect, 1 case of mitral stenosis, 2 cases of patent ductus arteriosus, and 1 case of atrial septal defect.(3)There were 23 cases according to combined cardiac axis angle measurements, and 18 cases were finally diagnosed with congenital heart disease. Compared with the individual test methods, the combined test showed increases in accuracy and specificity(P<0.05). The sensitivity of the combined test was not different from that of the DV spectrum test(P>0.05), but higher than that of the cardiac axis angle test(P<0.05).Conclusions The combined test of fetal cardiac axis angle and DV spectrum has higher diagnostic efficiency of congenital heart disease than the individual test alone.