The patient was 36 years old, 28 weeks pregnant, 2nd child, with a history of epilepsy. She was admitted to the hospital mainly for hyperemesis and antepartum zygote. On ultrasonography, the fetus had a biparietal diameter of 71 mm, a head circumference of 260 mm, a femur of 53 mm, a humerus of 48 mm, a transverse cerebellar diameter of 39 mm, a fetal heart rate of 115 beats/min and a regular heart rhythm. No abnormalities were found in brain structure, spine of limbs, abdominal organs, both lungs and amniotic fluid. Placental maturity grade 1~2, no abnormal structure size, S/D5.0, increased. Ultrasound examination of the fetal heart was normal in size and shape. The anterior wall of the right heart cavity near the apex and the septum right heart 14mm×8.2mm15mm×7.5mm hyperechoic nodules were convex to the heart cavity, oval in shape, with regular borders and uniform internal echogenicity. The two nodules grew in correspondence, narrowing the right heart cavity significantly, and a thin linear blood flow signal was visible in the middle (Figure 1 and 2). Ultrasound impression: intrauterine pregnancy, single live fetus, cephalic position, fetal bradycardia , fetal cardiac occupying lesion (consider lipoma), increased S/D ratio of placental blood supply. Fetal autopsy: the fetal heart was normal in shape, with normal outflow and inflow tracts, normal valve structure, and continuous atrial septum. Fatty projections were seen on the right anterior wall of the right ventricle and the right side of the ventricular septum, and the length and diameter were consistent with the ultrasound measurements (Figure 3 and Figure 4). Pathological diagnosis: lipoma (Figure 5). The incidence of cardiac lipoma accounts for about 8% of intracardiac tumors and has the same appearance as that of lipomas occurring in other parts of the body. It consists of mature adipocytes, a few fibrous tissues, small blood vessels and lymphatic vessels. The tissue composition is homogeneous, the surface is smooth, and there is a thin film of fibrous tissue, which forms the echogenic features of clear margins, regular morphology and smooth uniformity, and this case also has this feature. Lipomas mostly occur at the epicardium and pericardium, while subendocardial lipomas are rare and are divided into two categories: tipped and non-tipped. The effect of fetal cardiac lipoma on heart rate is unclear. The slowed heart rate of this fetus is related to hyperemesis gravidarum to increased S/D and hypoxia. The fetal heart lipoma had no effect on physical development, so no abnormalities were observed in other organs and parts of the fetus.