Association between Fetal Adrenal Gland Ultrasound Measurements in the 9th Month and Mode of Delivery

Abstract

Objective Several studies have previously assessed the value of changes in the fetal adrenal gland to predict preterm labor. The aim of this study is to evaluate the correlation between fetal adrenal gland measurements after 36 weeks and obstetrical outcomes.

Methods Abdominal two-dimensional (2D) ultrasound is used to measure in the transversal plane the length of fetal zone (D1), the width (D2), and the length (D3) of fetal adrenal gland, and, subsequently, the fetal zone enlargement (FZE), in 98 primigravida women after 36 weeks. Labor and delivery outcomes were assessed and compared with these measurements.

Results FZE changes had no association with spontaneous onset of labor. No association was found between all adrenal gland measurements and delivery onset. There was a significant relationship between D1, D2, and D3 and the delivery method. Patients delivered by cesarean section had smaller fetal adrenal gland dimensions, defining D1= 0.16 cm, D2 = 0.7 cm, and D3 = 2.37 cm as cutoff levels based on receiver operator characteristics curves.

Conclusion The 2D measurement of the fetal adrenal gland after 36 weeks seems to predict the delivery method in low-risk primigravida women.

Key Points

• We evaluate fetal adrenal gland measurements after 36 weeks versus the obstetrical outcome.

• No association was found between all adrenal gland measurements and delivery onset.

• Patients delivered by cesarean section had smaller fetal adrenal gland dimensions.

Keywords

Adrenal - Fetal - Fetal zone enlargement - Mode of delivery - Ultrasound

Synopsis

Fetal adrenal gland dimensions in the 9th month are not correlated to the spontaneous onset of labor but may be associated with the mode of delivery.

Publication History

Received: 27 January 2021

Accepted: 18 February 2022

Accepted Manuscript online:
03 March 2022

Article published online:
21 April 2022

• References

• 1 The Lancet. The unfinished agenda of preterm births. Lancet 2016; 388 (10058): 2323
• 2 Abdelazim IA, Abu Faza ML. Sonographic assessment of the cervical length before induction of labor. Asian Pac J Reprod 2012; 1 (04) 253-257
• 3 Abdelazim IA. Fetal fibronectin (Quick Check fFN test(®)) for detection of premature rupture of fetal membranes. Arch Gynecol Obstet 2013; 287 (02) 205-210
• 4 Irani RA, Foster S. Overview of the mechanisms of induction of labor. Semin Perinatol 2015; 39 (06) 426-429
• 5 Guler AE, Pehlivan H, Cakmak B, Baser I. Assessment of fetal adrenal gland enlargement in term and preterm labor cases. Int J Res Med Sci. 2017; 3 (05) 1035-1040
• 6 Gimovsky AC, Pham A, Shlossman P, Hoffman M. Fetal adrenal gland size and the ability to predict spontaneous term labor. Eur J Obstet Gynecol Reprod Biol 2019; 240: 341-346
• 7 Beshay VE, Carr BR, Rainey WE. The human fetal adrenal gland, corticotropin-releasing hormone, and parturition. Semin Reprod Med 2007; 25 (01) 14-20
• 8 Ibrahim MI, Sherif A, El-Kady M. et al. Can three-dimensional ultrasound measurement of fetal adrenal gland enlargement predict preterm birth?. Arch Gynecol Obstet 2015; 292 (03) 569-578
• 9 Langlois D, Li JY, Saez JM. Development and function of the human fetal adrenal cortex. J Pediatr Endocrinol Metab 2002; 15 (Suppl. 05) 1311-1322
• 10 Turan OM, Turan S, Funai EF, Buhimschi IA, Copel JA, Buhimschi CS. Fetal adrenal gland volume: a novel method to identify women at risk for impending preterm birth. Obstet Gynecol 2007; 109 (04) 855-862
• 11 Turan OM, Turan S, Funai EF. et al. Ultrasound measurement of fetal adrenal gland enlargement: an accurate predictor of preterm birth. Am J Obstet Gynecol 2011; 204 (04) 311.e1-311.e10
• 12 Agarwal S, Agarwal A, Joon P, Saraswat S, Chandak S. Fetal adrenal gland biometry and cervical elastography as predictors of preterm birth: a comparative study. Ultrasound 2018; 26 (01) 54-62
• 13 Goletzke J, Pagenkemper M, Wiessner C. et al. Longitudinal adrenal gland measurements and growth trajectories as risk markers for late preterm delivery. BMC Pregnancy Childbirth 2020; 20 (01) 570
• 14 Hoffman Sage Y, Lee L, Thomas AM, Benson CB, Shipp TD. Fetal adrenal gland volume and preterm birth: a prospective third-trimester screening evaluation. J Matern Fetal Neonatal Med 2016; 29 (10) 1552-1555
• 15 Abdallah W, Abi Tayeh G, Cortbaoui E. et al. Cesarean section rates in a tertiary referral hospital in Beirut from 2018 to 2020: our experience using the Robson Classification. Int J Gynaecol Obstet 2022; 156 (02) 298-303