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Fetal adrenal gland biometry and cervical elastography as predictors of preterm birth: A comparative study
Shubhra Agarwal1, Arjit Agarwal2, Pawan Joon2
11Department of Obstetrics & Gynecology, Teerthanker Mahaveer Medical College and Research Centre, Teerthanker Mahaveer University, Moradabad, India.
Insights
New ultrasound markers, including cervical elastography (shear wave speed) and fetal adrenal gland size, show high accuracy in predicting preterm birth. These quantitative measures offer a reliable method for early detection and prevention of complications.
Area of Science:
- Obstetrics and Gynecology
- Medical Imaging
- Fetal Medicine
Background:
- Preterm birth poses significant global health challenges, increasing healthcare costs and leading to long-term neurodevelopmental issues.
- Accurate prediction of preterm birth is crucial for timely intervention and reducing associated morbidities.
Purpose of the Study:
- To evaluate the predictive role of novel quantitative markers for preterm birth.
- To assess the relative importance of cervical elastography (shear wave speed) and fetal adrenal gland parameters in preterm birth prediction.
Main Methods:
- A case-control study included 30 pregnant women with preterm birth signs and 30 controls (term birth).
- Trans-abdominal ultrasonography was used to measure cervical length, cervical shear wave speed (dynamic elastography), and fetal adrenal gland parameters.
Main Results:
- Cervical shear wave speed demonstrated high sensitivity (96.7%) and specificity (87%) for preterm birth prediction.
- Fetal adrenal zone enlargement was also a reliable marker, though less sensitive and specific than cervical shear wave speed.
- A strong correlation was observed between cervical shear wave speed and fetal adrenal gland enlargement.
Conclusions:
- Elastographic advancements and fetal adrenal biometry provide objective criteria for accurate preterm birth prediction.
- These quantitative markers can aid in early detection and management of preterm birth.
Background:
Preterm birth is a major health problem in developing and developed countries leading to rising health care costs and long-term neurodevelopmental disability. The study aims to evaluate the role of new quantitative markers, like the elastography of cervix (shear wave speed estimation), fetal adrenal zone enlargement, and corrected fetal adrenal gland volume; in preterm birth prediction and analyze their relative importance. Thus, these markers may be beneficial in early preterm birth detection and prevent the related morbidities.
Methods:
Thirty pregnant females (from 28 to 37 weeks of gestational age), showing clinical signs and delivery outcome of preterm birth were included in the study with an equal number of not-in-labor antenatal females at ≥37 weeks as controls. These patients were categorized as preterm and term groups. Both the groups were subjected to trans-abdominal ultrasonography where cervical length, cervical shear wave speed (dynamic elastography) and fetal adrenal gland parameters were measured.
Results:
Shear wave speed estimation of the antenatal cervix showed the highest sensitivity and specificity (96.7% and 87% respectively) in the prediction of preterm birth and also showed a strong correlation with fetal adrenal gland enlargement. Fetal adrenal zone enlargement was also shown to be a reliable marker of preterm birth, however, with reduced sensitivity and specificity than shear wave speed.
Conclusion:
The elastographic advancement and fetal adrenal biometry derived quantitative markers can be used as an objective and standard criterion for accurate prediction of preterm birth.
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