The objective of this study was to evaluate the fetal cardiac function in human pregnancies exposed to sertraline (a selective serotonin reuptake inhibitor) compared to unexposed pregnancies. We included 44 women in gestational week 25 + 0 days to week 26 + 6 days. Fifteen women used sertraline (50-150 mg per day), and 29 women used no daily medication. We assessed fetal cardiac function by Myocardial Performance Index (MPI), E/A ratios and by tricuspid and mitral annular plane systolic excursion (TAPSE and MAPSE) measured by 2D M-mode and by 4D eSTIC M-mode. There were no differences between the sertraline exposed and the unexposed. The mean difference of MPI was 0.03 (95% CI −0.08-0.03), of tricuspid and mitral E/A ratios 0.00 (95% CI −0.03-0.05) and 0.03 (95% CI −0.07-0.01), respectively. The mean difference of TAPSE, by 2D and eSTIC, was 0.07 mm (95% CI −0.56-0.41) and 0.10 mm (95% CI −0.55-0.34). Mean difference of MAPSE, by 2D and eSTIC was 0.16 mm (95% CI −0.22-0.53) and 0.24 mm (95% CI −0.16-0.65), respectively. Serum levels of sertraline in exposed participants ranged from 33-266, median 92 nmol/L. We found no significant differences in fetal cardiac function, assessed by TAPSE, MAPSE, MPI and E/A ratios, in pregnancies exposed to sertraline compared to the unexposed.