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OBJECTIVE: We present a simple 2D big ultrasound measurement of the fetal adrenal glands and their biometrical growth analysis highlighted as a potential preterm birth marker. METHODS: This was a prospective observational case-control study. Sixty-four patients were included in the study (32 with the diagnosis of imminent preterm birth before 37 and 32 controls) from January 2018 to May 2020. Anteroposterior dimensions and circumferences of the whole adrenal glands and their central zones were measured by simple B-mode ultrasound imaging. For the statistical analysis, StatsDirect 3.0 and ROC curves were used. As a studied descriptor, routine standard ultrasound cervical measurements were added (cervical length, funneling, sludge, cervical dilatation, and cervical glandular area). RESULTS: In biometrics of gestational age-related changes, a signifi cant analysis of the overall growth of the adrenal gland was observed (circumference p < 0.001, anteroposterior diameter p = 0.02). The growth of the central zone was observed independently of gestational age. The growth of the central zone of the fetal adrenal glands revealed signifi cant changes between the group of patients who delivered prematurely and control groups (p < 0.01). The ideal cut-off value of the proportion of enlargement of the fetal zone as a predictor of preterm delivery before week 37 was 45.1 %, with the sensitivity of 87.5 % and specifi city of 85.4 %. CONCLUSIONS: A simple 2D B-mode measurement of the fetal adrenal glands´ central zone growth can be applied as an additional marker in the prediction of true preterm delivery. The natural biometrical overall growth of the adrenal glands seems to be dependent on gestational age, whereas that of the central adrenal gland zone seems to be independent on gestational age (Tab.

OBJECTIVES: To perform a complex review of HELLP syndrome and its treatment from up to date scientifi c literature. Study of the interresting treatement regime of the patient. METHODS: Complex analysis of the syndrome, systematic search of medical scientifi c databases and Slovak Medical Library. Analysis of the life threatening state of the patient, retrospective analysis of the diagnostics, treatment, acute management, complications and clinical results. RESULTS: According to up to date literature and our good clinical experiences we can encourage the use of high-dose corticosteroid therapy in HELLP syndrome. CONCLUSION: The most recent studies defi nitely recommend the high dose corticosteroid treatment in recovery management by the HELLP syndrome. We have used the high-dose corticosteroid regime as a recovery management for the patient with postpartum HELLP with very good clinical and laboratory response followed by prompt recovery of the patient and without other complications. We want to support and empasize the indication of the Dexamethasone regiment by HELLP, becouse the clinical experiences with this treatment are not well-known and usually the corticosteroids are not given to the patients with HELLP, or the treatment is "daemonized". Our clinical experience with this treatment was successful and the patient defi nitely profi ted of it. We support the opinion, that the benefi t of described regiment highly exceedes the possible adverse effects of the therapy (Fig. 8, Ref. 61). Text in PDF www.elis.sk.