Ultrasound measurement of the transverse diameter of the fetal thymus in pregnancies complicated by the preterm prelabor rupture of membranes

Musilová, Ivana; Hornychová, Helena; Košťál, Milan; Jacobsson, Bo; Kacerovský, Marian

doi:10.1002/jcu.22027

Cited by 30 publications

(37 citation statements)

References 31 publications

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“…Recently, Musilova et al [11] evaluated the FTTD in a single measurement on admission in 216 fetuses from PPROM pregnancies and observed that a small FTTD below 5% (according to the nomograms from their previous study [17]) was present in 80% (106/133) and 88% (36/41) of women with histologic chorioamnionitis and funisitis, respectively. The presence of a small FTTD had a sensitivity of 79%, specificity of 47%, PPV of 71%, and NPV of 59% for the identification of chorioamnionitis (p < 0.0001; odds ratio 3.5) and a sensitivity of 88%, specificity of 35%, PPV of 24%, and NPV of 92% in the identification of funisitis (p = 0.004; odds ratio 4.4).…”

Section: Discussionmentioning

confidence: 99%

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Serial Ultrasonographic Examination of the Fetal Thymus in the Prediction of Early Neonatal Sepsis in Preterm Premature Rupture of Membranes

Çetin

Cetin

Uludağ

et al. 2014

Gynecol Obstet Invest

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Background/Aims: To evaluate the diagnostic accuracy of fetal thymus transverse diameter (FTTD) in predicting fetal infection in preterm premature rupture of membranes (PPROM) and compare its accuracy with cord blood tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Methods: Forty consecutive pregnancies complicated with PPROM between 26^1/7 and 36^6/7 gestational weeks were evaluated prospectively. Serial fetal ultrasonography follow-ups with 3-day intervals were performed beginning on the admission day. The FTTD was recorded on every ultrasonographic examination. Cord blood TNF-α and IL-6 values were measured after delivery. Results: FTTD was decreased below 5% according to nomograms compared to the initial measurement in 45% of all PPROM cases. Decreased FTTD had a sensitivity of 100%, specificity of 73%, positive predictive value of 55%, and negative predictive value of 100% in predicting early neonatal sepsis. Cord blood TNF-α had a sensitivity of 80% and specificity of 90%, whereas IL-6 had a sensitivity of 90% and specificity of 63.3% in predicting early neonatal sepsis. Conclusions: Assessment of the decrease in FTTD by serial ultrasonographic examinations is a promising ‘prenatal' method for the early detection of early neonatal sepsis.

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Section: Discussionmentioning

confidence: 99%

“…The transverse diameter of the fetal thymus (FTTD) below the fifth percentile for the gestational age was found to be associated with histologic chorioamnionitis and funisitis [11]. If FTTD can predict histologic chorioamnionitis and funisitis, it may also predict early neonatal sepsis.…”

Section: Introductionmentioning

confidence: 99%

Serial Ultrasonographic Examination of the Fetal Thymus in the Prediction of Early Neonatal Sepsis in Preterm Premature Rupture of Membranes

Çetin

Cetin

Uludağ

et al. 2014

Gynecol Obstet Invest

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“…11,13,[27][28][29] Consequently, methods have been developed to visualize and measure the thymus using sonography, and the feasibility of these methods is similar (Table 6). [30][31][32][33][34] However, the need to include color Doppler imaging to visualize the internal mammary arteries can diminish the accuracy of visualization, especially in adverse fetal positions.…”

Section: View Viii: the Thy-boxmentioning

confidence: 99%

Cardiovascular System Sonographic Evaluation Algorithm

León-Luis

Bravo

Gámez

et al. 2015

J of Ultrasound Medicine

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Objectives To evaluate the reproducibility and feasibility of the new cardiovascular system sonographic evaluation algorithm for studying the extended fetal cardiovascular system, including the portal, thymic, and supra‐aortic areas, in the second trimester of pregnancy (19–22 weeks). Methods We performed a cross‐sectional study of pregnant women with healthy fetuses (singleton and twin pregnancies) attending our center from March to August 2011. The extended fetal cardiovascular system was evaluated by following the new algorithm, a sequential acquisition of axial views comprising the following (caudal to cranial): I, portal sinus; II, ductus venosus; III, hepatic veins; IV, 4‐chamber view; V, left ventricular outflow tract; VI, right ventricular outflow tract; VII, 3‐vessel and trachea view; VIII, thy‐box; and IX, subclavian arteries. Interobserver agreement on the feasibility and exploration time was estimated in a subgroup of patients. The feasibility and exploration time were determined for the main cohort. Maternal, fetal, and sonographic factors affecting both features were evaluated. Results Interobserver agreement was excellent for all views except view VIII; the difference in the mean exploration time between observers was 1.5 minutes (95% confidence interval, 0.7–2.1 minutes; P < .05). In 184 fetuses (mean gestational age ± SD, 20 ± 0.6 weeks), the feasibility of all views was close to 99% except view VIII (88.7%). The complete feasibility of the algorithm was 81.5%. The mean exploration time was 5.6 ± 4.2 minutes. Only the occiput anterior fetal position was associated with a lower frequency of visualization and a longer exploration time (P < .05). Conclusions The cardiovascular system sonographic evaluation algorithm is a reproducible and feasible approach for exploration of the extended fetal cardiovascular system in a second‐trimester scan. It can be used to explore these areas in normal and abnormal conditions and provides an integrated image of extended fetal cardiovascular anatomy.

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“…The finding of thymus agenesis or hypoplasia has been associated with 22q11 microdeletion in the presence of conotruncal anomalies 2 . Thymic hypoplasia is also a common finding in cases of preterm prelabor rupture of membranes, intrauterine growth restriction, maternal preeclampsia, and fetuses affected with Down syndrome and other aneuploidies, which may explain the immune function impairment in those cases 3 – 10 …”

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confidence: 99%

The Thy‐Box for Sonographic Assessment of the Fetal Thymus

Muñoz-Chapuli

Gámez

Bravo

et al. 2015

J of Ultrasound Medicine

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Ultrasound measurement of the transverse diameter of the fetal thymus in pregnancies complicated by the preterm prelabor rupture of membranes

Abstract: The sonographic finding of a small thymus is a sensitive indicator of histologic chorioamnionitis or funisitis; low specificity excludes it as a possible clinical implication in the management of PPROM pregnancies.

Cited by 30 publications

References 31 publications

Serial Ultrasonographic Examination of the Fetal Thymus in the Prediction of Early Neonatal Sepsis in Preterm Premature Rupture of Membranes

Serial Ultrasonographic Examination of the Fetal Thymus in the Prediction of Early Neonatal Sepsis in Preterm Premature Rupture of Membranes

Cardiovascular System Sonographic Evaluation Algorithm

The Thy‐Box for Sonographic Assessment of the Fetal Thymus

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