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Conservative management of cervical pregnancy using local injection has been reported to have a low complication rate and a high efficacy for cure.

Agreement in identifying chorionic bumps is near-perfect. A sonographically nonisolated chorionic bump is not associated with significant additional aneuploidy risk, whereas a sonographically isolated chorionic bump confers a significantly increased likelihood of aneuploidy in high-risk fetuses. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:3-7, 2017.

Objective To estimate whether ultrasound measurement of the fetal adrenal gland remote from delivery in asymptomatic women can accurately predict spontaneous preterm birth. Methods We conducted a prospective multicenter observational nested cohort study of asymptomatic nulliparous women with a singleton pregnancy to study adverse pregnancy outcomes. Between 22 0/7 and 30 6/7 weeks of gestation, credentialed ultrasonographers measured the width (w), length (l), and when able, depth (d) of the “fetal zone” of the fetal adrenal gland as well as the width (W), length (L) and depth (D) of the total gland. We used the ratios of each measurement (w/W, l/L and d/D) to control for variation in adrenal size by gestational age. The accuracy of each ratio measurement in predicting spontaneous preterm birth <37 0/7 weeks (“SPTB37”) and spontaneous preterm birth <34 0/7 weeks (“SPTB34”) was assessed by receiver operating characteristic (ROC) curves, using area under the curve (AUC). Results Pregnancy outcomes were available for 1,697 women with one or more fetal adrenal gland measurements. SPTB37 and SPTB34 occurred in 82 (4.8%) and 6 women (0.4%), respectively. None of the fetal adrenal gland measurements distinguished spontaneous preterm birth from term birth. The AUCs (95% CIs) for SPTB37 were 0.51 (0.45, 0.58), 0.50 (0.44, 0.56), and 0.52 (0.41, 0.63) for w/W, l/L and d/D ratios, respectively. The AUCs for SPTB34 were 0.52 (0.25, 0.79) and 0.55 (0.31, 0.79) for w/W and l/L ratios. Additionally, none of the means of the gland measurements were statistically different between those delivering at term and spontaneous at preterm (p>0.05). Conclusion Fetal adrenal size, as measured by ultrasound between 22 0/7 and 30 6/7 weeks, is not predictive of spontaneous preterm birth in asymptomatic nulliparous women.