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Objective To determine whether a modified myocardial performance index (Mod-MPI) involving assessment of the movements (clicks) of the mitral valve (MV) and aortic valve (AV), improves intra-and interobserver agreement as compared to the previously reported method for MPI estimation. Methods Results There was a significantly lower intra-and interobserver variability in the estimation of all time periods with the Mod-MPI than with the F-MPI (ICT : intraobserver, 9.9% vs. 13.9%; interobserver 9.9% vs. 15.6%; IRT: intraobserver, 9.9% vs. 14.8%; interobserver 10.4% vs. 18.3%; and ET: intraobserver, 4.5% vs. 6.1%; interobserver 2.8% vs. 5.2%, respectively). Intraclass correlation coefficient (IntraCC) for the ) and for the F-MPI, the IntraCC was 0.62 (95% CI, Conclusion Calculation of the Mod-MPI based on Doppler echoes of the MV and AV clicks is associated with a lower variation and better inter-and intraobserver agreement than the previously used method for fetal cardiac evaluation.