The risk of intrauterine death increases significantly in women with severe intrahepatic cholestasis of pregnancy. Fetal cardiac factors are considered to be possible important causes. However, the mechanisms of intrahepatic cholestasis of pregnancy causing fetal cardiac damage are still unclear. The possible mechanisms focus on the theories of acute hypoxia of the placenta and the toxic effects of bile acids. In this paper we summarize the studies on fetal heart damage caused by intrahepatic cholestasis of pregnancy, with a view to raising awareness of this disease.