Related Experiment Video
Updated: Aug 15, 2026
A Pipeline to Characterize Structural Heart Defects in the Fetal Mouse
Published on: December 16, 2022
Changes in cardiac morphometry in fetuses with lower urinary tract obstruction
Sarah Araji1,2, Betul Yilmaz Furtun3, Sara Al-Haddad1
1Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine Texas Children's Hospital Baylor College of Medicine Houston Texas USA.
Objective:
Fetal lower urinary tract obstruction (LUTO) is associated with significant perinatal morbidity due to oligohydramnios, pulmonary hypoplasia, and progressive renal dysfunction. In addition to these well-known sequelae, LUTO has been linked to various cardiac abnormalities on prenatal imaging, including cardiomegaly; ventricular hypertrophy; pericardial effusion; and, in some cases, relatively small left-sided cardiac structures. This study aimed to comprehensively characterize detailed fetal echocardiographic features in LUTO and compare them with gestational age (GA)-matched controls, adjusting for estimated fetal weight (EFW), with an emphasis on quantitative cardiac dimensions.
Methods:
This retrospective cohort study included fetuses diagnosed with isolated LUTO who underwent at least one fetal echocardiogram at our institution from 2013 to 2025. Fetuses with known genetic abnormalities or additional major structural anomalies were excluded. Controls consisted of GA-matched (1:1) fetuses with normal cardiac anatomy. Quantitative cardiac measurements were compared between groups and adjusted for EFW.
Results:
Among 117 LUTO fetuses who underwent at least one fetal echocardiogram, qualitative findings included pericardial effusion (29%), right ventricular hypertrophy (27%), and left ventricular hypertrophy (25%). Compared with controls, LUTO fetuses demonstrated significantly higher cardiothoracic ratio and smaller cardiac structures, including the mitral and tricuspid valves, aortic and pulmonary valves, and branch pulmonary arteries (all p < 0.01). These differences remained significant after adjustment for EFW.
Conclusion:
Fetuses with LUTO demonstrate global cardiac morphometric changes, affecting both the left- and right-sided structures. These may reflect impaired diastolic filling or decreased venous return. Our findings highlight the potential value of serial fetal echocardiography particularly following fetal intervention for monitoring cardiac adaptation and informing perinatal counseling.
