Skip to main content
SMFM 2026 Pregnancy Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared outside of the session
Faculty have requested this content not be shared outside of the session
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
Poster Icons
Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 4

Category: Ultrasound/Imaging

Poster Session 4

(1245) Changes in Cardiac Morphometry in Fetal Lower Urinary Tract Obstruction

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Objective:
Fetal lower urinary tract obstruction (LUTO) can lead to oligohydramnios, pulmonary hypoplasia, and eventual renal failure. It is also frequently associated with abnormal cardiac findings on prenatal imaging, including cardiomegaly, ventricular hypertrophy, and pericardial effusion. Some studies have additionally reported small left-sided cardiac structures. This study aimed to 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.

Study Design:
This retrospective cohort study included fetuses diagnosed with isolated LUTO who underwent at least one fetal echocardiogram at our institution from 2013 to 2024. Fetuses with associated chromosomal abnormalities or additional major anomalies were excluded. Controls were 1:1 GA-matched fetuses with normal cardiac anatomy. Quantitative cardiac measurements were compared between groups and adjusted for EFW. Logistic regression analysis was used to assess cardiac variables as predictors of LUTO, reported as adjusted odds ratios (ORs) with 95% confidence intervals (Figure 1).

Results:

Among 121 LUTO fetuses, qualitative findings included pericardial effusion (27%), right ventricular hypertrophy (16.5%) and left ventricular hypertrophy (14.8%). Compared with controls, LUTO fetuses had 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 EFW adjustment.

Conclusion:
In addition to previously reported findings, LUTO fetuses 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 suggest a potential role for serial fetal echocardiography—especially post-intervention—to monitor evolving cardiac physiology and guide prenatal counseling.