Fetal cardiac morphological assessment as part of fetal cardiac remodelling in cases with preeclampsia. An observational case control study

  • Hagar Okda Faculty of medicine, Alexandria university
  • Amal Zaki Azzam
  • Hossam Ibrahim Azab
  • Hisham Hosny El Gammal
Keywords: Preeclampsia, fetal morphological changes, sphericity index, cardiothoracic ratio, atrial and ventricular diameters.


Background: Preeclampsia, which affects about 2%-8% of pregnancies, is a major cause of perinatal and maternal morbidity and mortality. The morphological assessment of the fetal heart conveys important information regarding the cardiovascular adaptation of a fetus in the face of vascular resistance in the uteroplacental circulation. The aim of this work was to assess fetal cardiac morphological changes as part of fetal cardiac remodelling of non growth retarded fetuses in pregnancies complicated with mild and severe preeclampsia.  

Methods: A case control study was performed at the ultrasound unit of El-Shatby Maternity University Hospital on 150 pregnant women who were divided into three groups. Group 1 included 40 mild preeclamptic pregnant women. Group 2 included 35 severe preeclamptic pregnant women and group 3 included 75 non preeclamptic pregnant women. Fetal ECHO included measurement of cardiothoracic ratio, aortic, pulmonary, mitral and tricuspid valve annuli, sphericity index, interventricular septum and left ventricle posterior wall diameter at systole and diastole and atrial and ventricular diameter lengths. Data were analysed using SPSS software.

Results: Atrial and ventricular diameter lengths, cardiothoracic ratio and left ventricular posterior wall diameter were lower in cases with preeclampsia while the sphericity index was higher in cases with preeclampsia. No difference between study groups regarding valves annuli and interventricular septum measurement.

Conclusions: Our study showed that fetuses of mothers with preeclampsia showed larger and hypertrophied hearts as shown in higher sphericity index but lower atrial and ventricular diameter length which indicate increased cardiac contractility as response to pressure overload which resulted from placental resistance.