Comparative Analysis of 2-D Versus 3-D Ultrasound Estimation of the Fetal Adrenal Gland Volume and Prediction of Preterm Birth

Turan, Özhan; Turan, Şifa; Buhimschi, Irina A.; Funai, Edmund F.; Campbell, Katherine; Bahtiyar, Mert O.; Harman, Chris; Copel, Joshua A.; Baschat, Ahmet; Buhimschi, Catalin S.

doi:10.1055/s-0032-1314887

Cited by 23 publications

(25 citation statements)

References 23 publications

(33 reference statements)

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“…Both adrenal enlargement and thymus involution reflect the end manifestations of a nonspecific, steroid‐mediated response to infection and other acute stressors 7 , 8 . This understanding has led to clinical interest in the sonographic assessment of fetal adrenal 9 , 10 and thymus glands 7 , 11 , 12 among patients at increased risk for preterm birth.…”

mentioning

confidence: 99%

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Brandt

Bastek

Wang

et al. 2016

J of Ultrasound Medicine

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reterm birth, which is defined as delivery before 37 weeks' gestation, is responsible for 35% of deaths in the first year of life and more than $26 billion in annual health care costs. 1 Current methods for identifying women at increased risk for preterm birth are inadequate. Although universal cervical length screening during the second-trimester anatomic survey may identify patients at risk for spontaneous preterm birth, many patients with normal second-trimester cervical length measurements will still have preterm birth. [2][3][4] Justin S. Brandt, MD, Jamie A. Bastek, MD, MSCE, Eileen Wang, MD, Stephanie Purisch, MD, Nadav Schwartz, MD Received July 2, 2015, ORIGINAL RESEARCHObjectives-Previous studies have demonstrated an association between adverse obstetric outcomes, such as preterm birth, and in utero inflammation. The fetal thymus, which can be visualized in the anterior mediastinum on obstetric sonography, may involute in response to such inflammation and thus may identify pregnancies at increased risk for these outcomes. We therefore sought to determine whether secondtrimester fetal thymus measurements are associated with preterm birth.Methods-Transabdominal fetal thymus measurements were prospectively obtained in singleton pregnancies at gestational ages of 18 weeks to 23 weeks 6 days during a 5-month period. The transverse and anterorposterior thymus diameters and the thymicthoracic ratio were measured. Delivery outcomes were collected from our clinical database. The primary outcome was preterm birth, which we defined as delivery between 24 weeks and 36 weeks 6 days. Small for gestational age (SGA) and pregnancyrelated hypertension, which are adverse obstetric outcomes that may also be associated with in utero inflammation, were included as secondary outcomes.Results-We included 520 patients with thymus measurements and obstetric outcome data. The prevalence of preterm birth was 12.3% (n = 64). None of the thymus measurements were associated with preterm birth. Similarly, there was no association between thymus measurements and SGA or pregnancy-related hypertension.Conclusions-Sonographic assessment of the second-trimester fetal thymus did not identify patients at increased risk for preterm birth, SGA, and pregnancy-related hypertension. Routine thymus measurements during the second-trimester anatomic scan are not clinically useful for prediction of preterm birth and other adverse outcomes.

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mentioning

confidence: 99%

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Brandt

Bastek

Wang

et al. 2016

J of Ultrasound Medicine

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“…[2][3][4]14 VOCAL has been the technique to demonstrate the highest diagnostic accuracy for determining the volume of the fetal gland, over bidimensional measurements. 15 In the present study, the total adrenal gland volume is the measurement used to obtain the most consistent association than other markers. Some other studies validate the c-AGV as a measurement of the adrenal gland not biased by the gestational age.…”

Section: Discussionmentioning

confidence: 87%

“…The measurement of the fetal adrenal gland by ultrasound has been validated by previous studies regarding preterm labor . VOCAL has been the technique to demonstrate the highest diagnostic accuracy for determining the volume of the fetal gland, over bidimensional measurements . In the present study, the total adrenal gland volume is the measurement used to obtain the most consistent association than other markers.…”

Section: Discussionmentioning

confidence: 88%

Sonographic Evaluation of Fetal Adrenal Gland in Gestational Diabetes

et al. 2017

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“…Turan et al [5,6,19] assessed fetal adrenal gland volume in a heterogeneous population of pregnant women, including 34% with premature rupture of membranes [5]. The mechanisms involved in preterm birth in the presence of premature membrane rupture are associated with inflammatory and infectious factors, and it is not known what effect these factors could have on the volume and vascularization of the fetal adrenal gland [20].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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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.

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Comparative Analysis of 2-D Versus 3-D Ultrasound Estimation of the Fetal Adrenal Gland Volume and Prediction of Preterm Birth

Cited by 23 publications

References 23 publications

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Sonographic Evaluation of Fetal Adrenal Gland in Gestational Diabetes

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

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