Comparative Evaluation of Fetal Adrenal Gland Volume in Cases of Preterm Labor Versus Gestationally Matched Controls

摘要

Objectives: Efforts have been made to objectively estimate fetal adrenal gland activity by measuring maternal/ fetal corticotropin releasing hormone (CRH) levels, CRH messenger RNA in human placenta and more recently the fetal adrenal gland volume estimation on ultrasonography. This study was planned to evaluate and compare the fetal adrenal gland volume in cases of preterm labor and gestationally matched controls. Study design: One hundred (100) pregnant women with singleton live pregnancy between 28 and 36 weeks of gestation were enrolled in the study to evaluate and compare the fetal adrenal gland volume in cases of preterm labor and gestationally matched controls. Materials and methods: The adrenal gland volume was assessed by three-dimensional ultrasonography, after which each woman was followed prospectively until delivery. Results: Primary outcome measures were spontaneous delivery within 5 days of ultrasonography, delivery before 37 completed weeks, and sonography-delivery interval. The secondary outcome measures were birth weight, fetal or neonatal death, major adverse neonatal outcomes, and need for neonatal intensive care admission. Data were analyzed statistically. Conclusions: Fetal adrenal gland volume should be further evaluated as a predictor of preterm birth. Additional prospective studies are still needed to confirm that three-dimensional ultrasound assessment of the fetal adrenal gland volume can assist clinicians with implementation of better therapeutic and preventive interventions for preterm birth.