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Objective: The study aimed to find a difference in the cardiac output (COP) between normal and intrauterine growth restricted (IUGR) fetuses and to clarify a heart-sparing effect in IUGR fetuses (a new issue). Material and methods: This single-center, prospective cohort study, was conducted at Assiut Woman's Health University Hospital, Egypt, prospectively registered at clinical trial. gov NCT03146507. Two hundred and ten women were included: women with normal pregnancy (Group A: N= 105) and women whose pregnancy was complicated by IUGR between 32 to 34 weeks gestation (Group B: N= 105) from 2017 to 2022. Women underwent fetal Doppler echocardiography, umbilical (UA), and middle cerebral (MCA) artery Doppler assessment. The primary outcome included the relative cardiac output ratio at 32-34 weeks. Changes in Doppler indices in the UA and MCA were also recorded. Data were analyzed …