{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:39:48Z","timestamp":1787510388821,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T00:00:00Z","timestamp":1572825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2019,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To describe fetal echocardiographic findings associated with lower urinary tract obstruction (LUTO) and to compare anatomic and hemodynamic measurements between fetuses with LUTO and gestational age (GA)\u2010matched controls, with an emphasis on quantitative indices of diastolic function and cardiac output.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a retrospective cohort study of fetuses diagnosed with severe LUTO with giant bladder, which underwent at least one fetal echocardiogram at our center between January 2005 and June 2018. Fetuses with major congenital heart disease were excluded. Control fetuses did not have any structural or functional abnormalities and were GA\u2010matched to the LUTO fetuses based on the time of the first fetal echocardiogram. Cardiac anatomy and hemodynamic measurements were compared between fetuses with LUTO and controls. In infants with LUTO, serial fetal and postnatal echocardiographic data were assessed, when available, and clinical outcomes were reviewed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Twenty\u2010six fetuses with LUTO and at least one fetal echocardiogram available were identified, one of which was excluded due to hypoplastic left heart syndrome, leaving 25 LUTO fetuses in the final cohort. The mean GA at the first fetal echocardiogram was 25.4\u2009\u00b1\u20095.1\u2009weeks in the LUTO group and 25.3\u2009\u00b1\u20095.0\u2009weeks in the control group. Common findings in fetuses with LUTO included cardiomegaly (40%), pericardial effusion (44%), right ventricular (RV) hypertrophy (64%) and left ventricular (LV) hypertrophy (48%). Compared with GA\u2010matched controls, LUTO fetuses had lower ascending aorta\n Z<\/jats:italic>\n \u2010score (\u22120.10\u2009\u00b1\u20090.94\n vs<\/jats:italic>\n \u22120.93\u2009\u00b1\u20091.03;\n P<\/jats:italic>\n \u2009=\u20090.02) and aortic isthmus\n Z<\/jats:italic>\n \u2010score (\u22120.14\u2009\u00b1\u20090.86\n vs<\/jats:italic>\n \u22121.62\u2009\u00b1\u20091.11;\n P<\/jats:italic>\n \u2009<\u20090.001), shorter mitral valve inflow time indexed to cardiac cycle length (0.46\u2009\u00b1\u20090.04\n vs<\/jats:italic>\n 0.41\u2009\u00b1\u20090.06;\n P<\/jats:italic>\n \u2009=\u20090.002), and worse (increased) LV myocardial performance index (0.39\u2009\u00b1\u20090.03\n vs<\/jats:italic>\n 0.44\u2009\u00b1\u20090.04;\n P<\/jats:italic>\n \u2009<\u20090.001). In addition, the ratio of RV to LV cardiac index was higher in LUTO fetuses compared with controls (1.62\u2009\u00b1\u20090.13\n vs<\/jats:italic>\n 1.33\u2009\u00b1\u20090.11;\n P<\/jats:italic>\n \u2009<\u20090.001). Of the 25 LUTO pregnancies, two were lost to follow\u2010up, three underwent elective termination of pregnancy and three ended in intrauterine fetal demise. Four (16%) patients had mildly hypoplastic left\u2010heart structures, comprising two with aortic arch hypoplasia and two with mitral and aortic stenosis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In addition to presenting with cardiomegaly, pericardial effusion and ventricular hypertrophy, fetuses with LUTO demonstrate LV diastolic dysfunction and appear to redistribute cardiac output as compared to control fetuses, which may contribute to the development of left\u2010heart hypoplasia. Copyright \u00a9 2019 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/uog.20271","type":"journal-article","created":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T13:28:13Z","timestamp":1553520493000},"page":"780-785","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Fetal cardiac findings and hemodynamic changes associated with severe lower urinary tract obstruction\n in utero<\/i>"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7627-3094","authenticated-orcid":false,"given":"J.","family":"Cohen","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology Columbia University Medical Center, New York\u2010Presbyterian Hospital New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Levasseur","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology Columbia University Medical Center, New York\u2010Presbyterian Hospital New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Simpson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine Columbia University Medical Center, New York\u2010Presbyterian Hospital New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine Columbia University Medical Center, New York\u2010Presbyterian Hospital New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1221-081X","authenticated-orcid":false,"given":"L.","family":"Freud","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology Columbia University Medical Center, New York\u2010Presbyterian Hospital New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2007.06.005"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2009.03.010"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14808"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7664"},{"issue":"392","key":"e_1_2_6_6_1","first-page":"e1","article-title":"The twin\u2010twin transfusion syndrome: spectrum of cardiovascular abnormality and development of a cardiovascular score to assess severity of disease","volume":"197","author":"Rychik J","year":"2007","journal-title":"Am J Obstet 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