Fetal adrenal gland biometry and cervical elastography as predictors of preterm birth: A comparative study

Agarwal, Sonal; Agarwal, Arjit; Joon, Pawan; Saraswat, Shalini; Chandak, Shruti

doi:10.1177/1742271x17748515

Cited by 41 publications

(45 citation statements)

References 31 publications

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“…This finding could be attributed to the pathologic nature of the cervical stroma, which is mainly composed of fibromuscular tissue, which is less dense than myometrium. To our knowledge, no previous examined SWE for the normal cervix, although there are multiple studies on the role of elastography, including strain elastography and acoustic radiation force impulse imaging, in the cervix for labor assessment and predicting preterm birth …”

Section: Discussionmentioning

confidence: 99%

Quantitative Sonoelastographic Assessment of the Normal Uterus Using Shear Wave Elastography: An Initial Experience

Manchanda

Vora

Sharma

et al. 2019

J of Ultrasound Medicine

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Objectives-To describe the sonoelastographic characteristics of the normal endometrium, myometrium, and cervix and to assess their variability with age and different menstrual phases.Methods-A total of 56 women were enrolled in this prospective study, who underwent transvaginal ultrasound examinations, including B-mode imaging and shear wave elastography. The elasticity parameters (in kilopascals) of the normal endometrium, myometrium, and cervix were studied. The variability of the mean elasticity value of the endometrium in different menstrual phases and age groups was analyzed. The variability of the mean elasticity of the cervix across different age groups was also studied.Results-The mean age of the participants was 40 years (range, 25-69 years). The normal mean elasticity values AE SDs were 25.54 AE 8.56 kPa for the endometrium, 40.24 AE 8.59 kPa for the myometrium, and 18.90 AE 4.22 kPa for the cervix. A mean endometrial-to-myometrial elasticity ratio was calculated, which was found to be 0.65 AE 0.22. There was no significant difference in the mean endometrial elasticity values for women in different menstrual phases (P = .176) or in different age groups (P = .376). There was no significant difference in the mean cervical elasticity with age (P = .192).Conclusions-Shear wave elastography is a promising adjunct to ultrasound for the evaluation of the uterus, and the results from this study may provide normal data, which may further help in diagnosing various uterine diseases.

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Section: Discussionmentioning

confidence: 99%

Quantitative Sonoelastographic Assessment of the Normal Uterus Using Shear Wave Elastography: An Initial Experience

Manchanda

Vora

Sharma

et al. 2019

J of Ultrasound Medicine

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“…The ratio between the fetal zone and the whole adrenal gland could accurately distinguish between patients with symptoms of preterm birth who delivered within the next week and those who did not with high sensitivity and specificity [15]. The groups of Santipap et al as well as Agarwal reported that in patients with either threatened preterm labour or preterm labour an enlarged adrenal gland in combination with high levels of placental alpha macroglobulin-1 or cervical elastography respectively was effective in predicting preterm delivery within 7 days [17,18]. The adrenal gland ratio was reported to be independent of gestational age [9] and is therefore particular useful for screening.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal adrenal gland measurements and growth trajectories as risk markers for late preterm delivery

Goletzke

Pagenkemper

Wiessner

et al. 2020

BMC Pregnancy Childbirth

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Background The fetal adrenal gland receives rising awareness as a predictor of spontaneous preterm birth. We hereby provide longitudinal growth assessments of the fetal adrenal gland in a low risk population with an additional focus on trajectories in fetuses born preterm. Methods Fetal adrenal gland was assessed via transabdominal ultrasound at gestational weeks (gw) 24–26, 28–30, and 34–36 in a low-risk pregnancy cohort. Longitudinal trajectories of the total gland and the mark (so called fetal zone) as well as ratio of fetal zone width/ total widths (w/W) were analyzed using repeated ANOVA analyses. To compare trajectories of the ratio w/W for preterm and term fetuses respectively, as well as women with and without clinical signs of preterm labor, the propensity score method was applied. Results Fetal zone width increased over the course of pregnancy (p < 0.0001), while the ratio w/W decreased (p < 0.0001) (n = 327). Comparing the trajectories of the ratio w/W in fetuses born preterm (n = 11) with propensity-score matched term born fetuses (n = 22), a decrease between gw 24–26 and 28–30 was observed in both groups, which continued to decrease for the term born fetuses. However, in preterm born fetuses, the ratio increased above the term born values at gw 34–36. Conclusion Our study provides for the first time longitudinal growth data on the fetal adrenal gland and supports the hypothesis that fetal zone enlargement is associated with preterm birth which could play an important role in risk-prediction.

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“…Two approaches for cervical ultrasound elastography for quantitative determination of the physical properties of the cervix, namely, strain elastography and shear wave elastography have been developed. We identified 11 clinical studies in the last three years, which tested the hypothesis that cervical elastography may be useful in predicting preterm delivery [20]- [25] [34] [35] [36] [37] [38]. Of the eleven studies identified, seven used strain ultrasound [20]- [25] [35] and four used shear wave ultrasound [34] [36] [37] [38].…”

Section: Discussionmentioning

confidence: 99%

Cervical Characterization with Tactile-Ultrasound Probe

Egorov¹,

Rosen

Raalte³

et al. 2020

OJOG

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Background: Premature cervical softening and shortening may be considered an early mechanical failure that predisposes to preterm birth. Preliminary clinical studies demonstrate that cervical elastography may be able to quantify this phenomenon and predict spontaneous preterm delivery. Objective: To explore a new approach for cervix elasticity and length measurements with tactile-ultrasound probe. Methods: Cervix probe has tactile array and ultrasound transducer designed to apply controllable load to cervix and acquire stress-strain data for calculation of cervical elasticity (Young's modulus) and cervical length for four cervix sectors. Average values, standard deviations, intraclass correlation coefficients and the 95% limits of agreement (Bland-Altman plots) were estimated. Results: Ten non-pregnant and ten pregnant women were examined with the probe. The study with non-pregnant women demonstrated a reliable acquisition of the tactile signals. The ultrasound signals had a prolonged appearance; identification of the internal os of the cervix in these signals was not reliable. The study with pregnant women with the gestational age of 25.4 ± 2.3 weeks demonstrated reliable data acquisition with real-time visualization of the ultrasound signals. Average values for cervical elasticity and standard deviations of 19.7 ± 15.4 kPa and length of 30.7 ± 6.6 mm were calculated based on two measurements per 4 sectors. Measurement repeatability calculated as intraclass correlation coefficients between two measurements at the same cervix sector on pregnant women was found to be 0.97 for cervical elasticity and 0.93 for the cervical length. The 95% limits of agreement of 1) cervical elasticity were from −22.4% to +14.9%, and 2) cervical length from −13.3% to +16.5%. Conclusions: This study demonstrated clinically acceptable measurement performance and reproducibility. The availability of stress-strain data allowed the computation of cervical elasticity and length. This approach has the potential to provide cervical markers to predict spontaneous preterm delivery.

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Fetal adrenal gland biometry and cervical elastography as predictors of preterm birth: A comparative study

Abstract: 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.

Cited by 41 publications

References 31 publications

Quantitative Sonoelastographic Assessment of the Normal Uterus Using Shear Wave Elastography: An Initial Experience

Quantitative Sonoelastographic Assessment of the Normal Uterus Using Shear Wave Elastography: An Initial Experience

Longitudinal adrenal gland measurements and growth trajectories as risk markers for late preterm delivery

Cervical Characterization with Tactile-Ultrasound Probe

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