Second trimester fetal thymus size in association to preterm birth

Porschen, Christian; Schmitz, Ralf; Schmidt, René; Oelmeier, Kathrin; Hammer, K; Falkenberg, Maria; Braun, Janina; Köster, Helen Ann; Steinhard, J.; Möllers, Mareike

doi:10.1515/jpm-2021-0065

Cited by 3 publications

(3 citation statements)

References 38 publications

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“…Some authors preferred to use a second trimester thymus-thorax ratio, defined as the quotient of anteroposterior thymus diameter and anteroposterior thoracic diameter. However, they failed to predict preterm birth, as there is no gold standard for thymus measurements 5 . Small thymus is associated with increased neonatal adverse outcomes in very low birth weight infants, such as bronchopulmonary dysplasia, respiratory distress syndrome, patent ductus arteriosus, retinopathy of prematurity, periventricular leukomalacia, and sepsis 26 , as thymic involution presumably occurs because of depletion of thymocytes.…”

Section: Discussionmentioning

confidence: 99%

“…In situations such as placental insufficiency, activation of fetal hypothalamic-pituitary-adrenal axis increases glucocorticoid levels, which stimulate morphological and functional changes in a wide range of tissues to ensure fetal survival including thymus involution 3 . This process is also reported in chorioamnionitis and fetal inflammatory response syndrome, and recently, it has been investigated in preeclampsia, maternal diabetes, and COVID-19 infection [4][5][6][7][8] . Small thymus is associated with an increased child mortality, and its postnatal evaluation can predict the likelihood of survival in preterm infants 9,10 .…”

Section: Introductionmentioning

confidence: 99%

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Fetal thymus in growth-restricted fetuses due to placental insufficiency

Takeno

Nomura

2023

Rev. Assoc. Med. Bras.

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OBJECTIVE:The aim of this study was to assess fetal thymus size by ultrasound in growth-restricted fetuses due to placental insufficiency and compare to high-risk and low-risk pregnancy fetuses with normal placental function. METHODS: This is a nested case-control study of pregnant women followed up at a university hospital (July 2012 to July 2013). In all, 30 pregnant women presenting small fetuses for gestational age (estimated fetal weight p95) were compared to 30 high-risk and 30 low-risk pregnancies presenting normal Doppler indices. The thymus transverse diameter and perimeter were converted into zeta score according to the normal values for gestational age. Head circumference and femur length were used to calculate ratios. RESULTS: Fetal thymus were significantly lower in pregnancies with placental insufficiency when compared to high-risk and low-risk pregnancies presenting, respectively, transverse diameter zeta score (-0.69±0.83 vs. 0.49±1.13 vs. 0.83±0.85, p<0.001) and P zeta score (-0.73±0.68 vs. 0.45±0.96 vs. 0.26±0.89, p<0.001). There was also a significant difference (p<0.05) in the ratios among the groups: pregnancies with placental insufficiency (TD/HC=0.10, P/FL=1.32, and P/HC=0.26), high-risk pregnancies (TD/HC=0.11, P/FL=1.40, and P/HC=0.30), and control group (DT/HC=0.11, P/ FL=1.45, and P/HC=0.31). CONCLUSION: Fetal thymus size is reduced in growth-restricted fetuses due to placental insufficiency, suggesting fetal response as a consequence of the adverse environment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fetal thymus in growth-restricted fetuses due to placental insufficiency

Takeno

Nomura

2023

Rev. Assoc. Med. Bras.

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“…Several European working groups followed with different fetal measurements (Table I). Cephalometry [32][33][34][35][36][37] Abdomino-/thoracometry [34,[38][39][40][41] Long limb bones [42][43][44][45] Assessing gestational age [46] Brain ventricle diameter [47] Cerebellar diameter [47,48] Orbital diameter [49] Thymus [50] Heart [51] Fetal measurements were also used to develop formulas to calculate the fetal weight [39,[52][53][54][55] and to detect fetal growth retardation [56,57]. Nowadays fetal growth charts for many fetal parameters have been developed by different European working groups [47,[58][59][60][61][62][63][64].…”

Section: Biometrymentioning

confidence: 99%

History of ultrasound in obstetrics and gynaecology from 1971 to 2021 on occasion of the 50 years anniversary of EFSUMB

Merz¹,

Evans

Dong

et al. 2023

Med Ultrason

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Diagnostic ultrasound in obstetrics and gynaecology has experienced a fantastic evolution during the past seven decades. Initial steps with A-mode technology were followed by B-mode and B-mode real-time imaging, then by Doppler and colour Doppler ultrasound, and finally by 3D/4D ultrasound. Other evolutionary steps were the development of high-resolution transabdominal and transvaginal transducers providing high quality images in the first, second and third trimesters of pregancy, as well as in gynaecology and breast imaging.The progression from two-dimensional (2D) to three-dimensional ultrasound (3D) and 3D real-time imaging (4D) has brought new options in displaying anatomical structures. In comparison with CT or MRI, it is not a static but functional technique, cheap and safe, and applicable at any time.

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Assessment of the fetal thymic-thoracic ratio in pregnant women with intrahepatic cholestasis: a prospective case-control study

Agaoglu,

Tanacan,

Bozkurt Ozdal

et al. 2024

Journal of Perinatal Medicine

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Objectives To examine the fetal thymic-thoracic ratio (TTR) in intrahepatic cholestasis of pregnancy (ICP). Methods This prospective case-control study was conducted in a single tertiary center. The sample consisted of 86 pregnant women at 28–37 weeks of gestation, including 43 women with ICP and 43 healthy controls. TTR was calculated for each patient using the anterior-posterior measurements of the thymus and intrathoracic mediastinal measurements. Results The median TTR value was found to be smaller in the ICP group compared to the control group (0.32 vs. 0.36, p<0.001). The ICP group had a greater rate of admission to the neonatal intensive care unit (NICU) (p<0.001). Univariate regression analysis revealed that lower TTR values increased the possibility of NICU admission six times (95 % confidence interval: 0.26–0.39, p=0.01). A statistically significant negative correlation was detected between TTR and the NICU requirement (r: −0.435, p=0.004). As a result of the receiver operating characteristic analysis, in predicting NICU admission, the optimal cut-off value of TTR was determined to be 0.31 with 78 % sensitivity and 67 % specificity (area under the curve=0.819; p<0.001). Conclusions We determined that the fetal TTR may be affected by the inflammatory process caused by the maternal-fetal immune system and increased serum bile acid levels in fetal organs in the presence of ICP. We consider that TTR can be used to predict adverse pregnancy outcomes in patients with ICP.

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Second trimester fetal thymus size in association to preterm birth

Cited by 3 publications

References 38 publications

Fetal thymus in growth-restricted fetuses due to placental insufficiency

Fetal thymus in growth-restricted fetuses due to placental insufficiency

History of ultrasound in obstetrics and gynaecology from 1971 to 2021 on occasion of the 50 years anniversary of EFSUMB

Assessment of the fetal thymic-thoracic ratio in pregnant women with intrahepatic cholestasis: a prospective case-control study

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