Fetal adrenal gland enlargement to predict preterm birth

January 01, 0001

Fetal adrenal gland enlargement to predict preterm birth

The objective of this study by US authors was to test whether ultrasound-measured fetal adrenal gland volume (AGV) and fetal zone enlargement (FZE) predicts preterm birth (PTB) better than cervical length (CL). Three-dimensional and 2-dimensional ultrasound were used prospectively to measure fetal AGV, FZE, and CL in women with preterm labor symptoms. They corrected AGV for fetal weight (cAGV). The ratio between whole gland depth (D) and central fetal zone depth (d) (d/D) was used to measure FZE. Ability of cAGV, d/D, and CL to predict PTB 7 days or less was compared.

They found: "Twenty-seven of 74 women (36.5%) presenting between 21 and 34 weeks had PTB of 7 days or less. FZE greater than 49.5% was the single best predictor for PTB (sensitivity/specificity 100%/89%) compared with cAGV (81%/87%) and CL (56%/60%). Prediction was independent of obstetrics history and tocolytic use."

The authors concluded: "The 2-dimensional measurement of the adrenal gland FZE is highly effective performing superior to CL in identifying women at risk for PTB within 7 days."

This study needs to be confirmed in other samples before applying in clinical practice.

For the full abstract, click here.

Am J Obstet Gynecol 204:311.e1-10
© 2011 to Elsevier, Inc.
Ultrasound measurement of fetal adrenal gland enlargement: an accurate predictor of preterm birth. Ozhan M. Turan, Sifa Turan, Edmund F. Funai, et al. Correspondence to Drs. Turan: sifa_ozhan@hotmail.com

Category: W. Pregnancy, Family Planning. Keywords: cervical length, fetal adrenal gland, preterm birth, 3-dimensional ultrasound, volume measurement, diagnostic test research, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 3 May 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.