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Measuring Fetal Adrenal Gland vs Cervical Length Better Predicts Preterm Birth CHICAGO -- February 4, 2010 -- Measuring the fetal zone of the adrenal gland is a better predictor of pre-term birth than measuring cervical length, according to a study presented today at the Society for Maternal-Fetal Medicine’s annual meeting. “We previously discovered that 3D adrenal gland volume (AGV) is a very accurate predictor of preterm birth,” said author Ozhan Turan, University of Maryland Medical Center, Baltimore, Maryland. Dr. Turan and colleagues have followed up on early research that they conducted using 3D ultrasound methods. “Most people around the world don’t have access to that technology; therefore, we have created measurements that can be done with 2D ultrasound that are very effective to predict pre-term birth.” In the study, patients presenting with preterm labour symptoms had ultrasound measurement of the cervical length (CL) and fetal adrenal gland dimension. Using 3D ultrasound with VOCAL cAGV (AGV/estimated fetal weight), 2D depth of the whole-gland (D) and fetal zone (d) were measured. The d/D ratio was calculated as an index of FZE. The cAGV, d/D and CL were compared for prediction of preterm birth within 7 days. Sixty-two singletons with preterm labour at 23 to 37 weeks gestation were studied. Measurement-to-delivery interval only correlated with cAGV and d/D (P = .001, respectively) but not CL (P = .83). A total of 20 women had preterm birth at less than 7 days (group A) while 42 (group B) delivered in 7 days or more from initial assessment. While CL was similar in both groups (P = .5), cAGV and d/D were higher in group A (P < .0001 for both). ROC area under the curve was greater for cAGV and d/D than for CL (0.82, 0.91, and 0.59, respectively) without any significant differences between adrenal gland measurements. Using ROC derived cutoffs for preterm birth in less than 7 days was best predicted by d/D and cAGV but not CL. “Prior to this we haven’t had a good method to predict who will present with pre-term labour.” said Dr. Turan. “Measuring the cervical length leads to a high percentage of false positives and also it has limited sensitivity. Hopefully, if adopted, this method will allow for an easy inexpensive way to identify real pre-term deliveries.” SOURCE: The Society for Maternal-Fetal Medicine E-mail this page to a friend or colleague! To print, use this version