Can fetal adrenal artery Doppler velocimetry predict delivery date in pregnant women with spontaneous preterm birth?

Abstract

Aim: To assess the accuracy of delivery date predictions made using fetal adrenal artery Doppler velocimetry in pregnant women with spontaneous preterm birth (PB) and to compare these predictions with cervical length (CL) measurements.Material and methods: A prospective study was performed with 51 pregnant women whose gestational lengths were between 24 and 36 weeks. The main outcome was the time between the Doppler velocimetry examination and delivery, categorized as delivery within 7 days or 7 days later after the examination. A receiver operating characteristics curve was performed to define the cutoffs among deliveries within 7 days for fetal adrenal artery Doppler velocimetry parameters and CL measurements.Results: The incidence of delivery within 7 days was 37.3%, with a statistically significant difference for the pulsatility index (PI; p=0.045) and resistance index (RI; p=0.030) of the fetal adrenal artery. The best cutoff values of PI and RI for predicting deliveries within 7 days were 1.65 and 0.78, respectively. The sensitivity and specificity of PI, RI, and CL (20 mm) were 73.7% (95% CI: 51.9–95.5) and 56.3% (95% CI: 38.1–74.4); 68.4% (95% CI: 45.4–91.4) and 62.5% (95% CI: 44.8–80.2); and 76.5% (95% CI: 54.0–99.0) and 78.1% (95%: CI 71.1–97.7), respectively.Conclusion: Fetal adrenal artery Doppler velocimetry can predict delivery within 7 days among pregnant women in cases of spontaneous PB and this prediction is similar to the predictions made using CL measurements.

Prediction of preterm birth by evaluating the fetal adrenal gland volume and blood flow: a pilot study

“…13,14 In present study, there was no significant change in PI and RI of fetal adrenal gland artery at time of Doppler in cases that delivered within 7 days and that delivered more than 7 days in compare to fetal adrenal volume which have greater predictive power for preterm birth in symptomatic pregnant women in comparison with the previous study done by Carvalho et al who assessed 51 singleton pregnancies and observed that that the fetal adrenal artery reduces its resistance in cases of imminent preterm birth and both PI and RI were good predictors of delivery within 7 days for pregnant women in cases of spontaneous preterm birth. 15 Present study had its limitations; firstly, single operator who evaluated all the cases and this limit the generalizability of the results. Additionally, the small sample size of included participants was another weak point.…”