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

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..

Fascia suturing during cesarean may be linked to the later occurrence of cesarean scar endometrioma.

The most common type of abdominal wall endometriosis is cesarean scar endometriosis (CSE), defined as the presence of endometrial tissue outside the uterine cavity. Multiple hypotheses can explain the implantation theory. Endometrioma are most commonly located on the fascia-muscles layer and on both side corners of the cesarean-section scar. By reviewing the surgical techniques used in the cesarean section, we hypothesize that the type of suture material, the knot in itself, and the angiogenesis could be factors that influence CSE development.