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Fetal Adrenal Gland Volume

A Novel Method to Identify Women at Risk for Impending Preterm Birth

From the Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut.

OBJECTIVE: To investigate the risk of preterm birth (delivery at less than 37 weeks of gestation) by evaluating the fetal adrenal gland volume, hallmark of activation of the fetal hypothalamic-pituitary-adrenal axis, measured by 3-dimensional ultrasonography.

METHODS: We performed 3-dimensional ultrasound examination of the fetal adrenal gland volume in 126 singleton fetuses, prospectively comparing those born to mothers with signs or symptoms of preterm labor (n=53) to control subjects (n=73). Multiplanar technique with rotational methods for measurement of fetal adrenal gland volume was performed by using Virtual Organ Computer-Aided Analysis (VOCAL) technology.

RESULTS: The fetal adrenal gland volume was successfully examined in 86.5% of the cases. There was a direct relationship between the fetal adrenal gland volume and estimated fetal weight. A corrected adrenal gland volume of greater than 422 mm³/kg was best in predicting preterm birth within 5 days from the time of the measurement. The sensitivity, specificity, and positive and negative likelihood ratios were 92%, 99%, 93.5, and 0.08, respectively. Multiple logistic regression analysis showed that the corrected adrenal gland volume was the only significant independent predictor factor of preterm birth within 5 days of measurement.

CONCLUSION: Corrected adrenal gland volume measurement may identify women at risk for impending preterm birth. This information can be generated noninvasively and in time for clinical decision making.

LEVEL OF EVIDENCE: II

This article has been cited by other articles:

				C. S. Buhimschi, O. M. Turan, E. F. Funai, H. Azpurua, M.-O. Bahtiyar, S. Turan, G. Zhao, A. Dulay, V. Bhandari, J. A. Copel, et al. Fetal Adrenal Gland Volume and Cortisol/Dehydroepiandrosterone Sulfate Ratio in Inflammation-Associated Preterm Birth Obstet. Gynecol., March 1, 2008; 111(3): 715 - 722. [Abstract] [Full Text] [PDF]

				N. N. Mahajan Fetal Adrenal Gland Volume: A Novel Method to Identify Women at Risk for Impending Preterm Birth Obstet. Gynecol., July 1, 2007; 110(1): 187 - 187. [Full Text] [PDF]