Can fetal adrenal artery Doppler velocimetry predict delivery date in pregnant women with spontaneous preterm birth?

AIM: To assess the accuracy of delivery date predictions made using fetal adrenal artery Doppler velocimetry in pregnant women with spontaneous preterm birth (PB) and to compare these predictions with cervical length (CL) measurements.Material and methods: A prospective study was performed with 51 pregnant women whose gestational lengths were between 24 and 36 weeks. The main outcome was the time between the Doppler velocimetry examination and delivery, categorized as delivery within 7 days or 7 days later after the examination. A receiver operating characteristics curve was performed to define the cutoffs among deliveries within 7 days for fetal adrenal artery Doppler velocimetry parameters and CL measurements. RESULTS: The incidence of delivery within 7 days was 37.3%, with a statistically significant difference for the pulsatility index (PI; p=0.045) and resistance index (RI; p=0.030) of the fetal adrenal artery. The best cutoff values of PI and RI for predicting deliveries within 7 days were 1.65 and 0.78, respectively. The sensitivity and specificity of PI, RI, and CL (20 mm) were 73.7% (95% CI: 51.9-95.5) and 56.3% (95% CI: 38.1-74.4); 68.4% (95% CI: 45.4-91.4) and 62.5% (95% CI: 44.8-80.2); and 76.5% (95% CI: 54.0-99.0) and 78.1% (95%: CI 71.1-97.7), respectively. CONCLUSION: Fetal adrenal artery Doppler velocimetry can predict delivery within 7 days among pregnant women in cases of spontaneous PB and this prediction is similar to the predictions made using CL measurements.

Delivery prediction in pregnant women with spontaneous preterm birth using fetal adrenal gland biometry.

OBJECTIVE: To assess the prediction of delivery within 7 days in pregnant women who showed symptoms of spontaneous preterm birth (PB) by means of fetal adrenal gland biometry and to compare these predictions with the cervical length (CL) measurement. METHODS: We performed a prospective cross-sectional study with 53 pregnant women between 24 and 36 weeks of gestation. An ultrasound exam was performed for each participant to obtain the CL measurement (transvaginal route) and fetal adrenal gland biometry on day 1 of their hospital admission because of symptoms of spontaneous PB. The main outcome measure was the time between the ultrasound exam and delivery, which was classified into two groups: delivery ≤7 days and delivery >7 days. A receiver operating characteristics (ROC) curve was performed to define the cutoffs for sensitivity and specificity. RESULTS: The prevalence of delivery within 7 days was 35.8%, which showed a statistically significant difference from the depth of the central zone of the fetal adrenal gland (p = 0.036). The cutoff for the depth of the central zone of the fetal adrenal gland was 7.2 mm (sensitivity 66.7%, specificity 61.8% and accuracy 63.5%). These values were not significantly different than the cutoffs for cervical length measurement: 20 mm (p = 0.267) and 9 mm (p = 0.118). CONCLUSION: The biometry for the central zone of the fetal adrenal gland predicted delivery within 7 days in pregnant women with spontaneous PB and had a predictive accuracy similar to that of CL measurement.

Predição de parto prematuro pela biometria e dopplervelocimetria da glândula adrenal fetal empacientes com sintomas de trabalho de parto prematuro

OBJETIVOS: O objetivo do presente estudo foi avaliar a capacidade de predição do partoprematuro através da biometria e da dopplervelocimetria da glândula adrenal fetal empacientes com sintomas de trabalho de parto prematuro e membranas íntegras e compará-loscom o poder de predição da medida do comprimento do colo uterino. Metodologia: O estudodo tipo transversal, prospectivo, foi realizado na Maternidade-Escola Assis ChateaubriandUFCde abril de 2014 a março de 2015 com cinquenta e sete pacientes consecutivamenteinternadas no setor de obstetrícia com idades gestacionais entre 24 e 36 semanas. Foramexcluídas as pacientes com diabetes, hipertensão, malformações ou restrição do crescimentofetais. Ultrassom foi realizada no primeiro dia da admissão para a medida do comprimento docolo uterino (transvaginal), biometria e dopplervelocimetria da glândula adrenal fetal. Avariável desfecho foi o tempo decorrido até o parto com subclassificação em dois grupos:aquelas que tiveram o parto em até sete dias ou depois do sétimo dia. Considerou-se nível designificância de p<0,05. Utilizou-se o teste Exato de Fisher para variáveis nominais o teste tStudentou de Mann-Whitney para as variáveis contínuas. Foi realizado curva ROC paradefinir pontos de corte...

OBJECTIVES: The purpose of this study is to evaluate the predicting capacity of the biometry offetal adrenal gland in patients who are undergoing symptoms of premature labor anduntouched membranes, and compare it with uterine collum measurement regarding suchprediction. Methodology: A transverse kind of study was accomplished at the “AssisChateubriand” Maternity School at the Federal University of Ceará from April 2014 to March2015 on fifty-seven (57) patients consecutively hospitalized at the obstetrics section atpregnant age ranged from 24 to 36 weeks. Patients suffering from diabetes, hypertension,malformations or fetal-development restriction were excluded. Ultrasound was carried out onthe first day of their hospitalization to measure the length of their uterine collum(transvaginal) as well as the biometry of their fetal adrenal gland. The main outcome variablewas the time elapsed until the delivery itself, with a subclassification into two groups: theones who had their delivery up to seven days or after the seventhy day. The significance levelconsidered was p< 0,05. The Fisher – Exact test was used for nominal variables and the Tstudentor the Mann-Whitney Test for continuous variables. The ‘ROC’ curve was carried outto define cutoffs...