title: Ultrasound measurement of fetal adrenal gland enlargement: an accurate predictor of preterm birth.
abstract: OBJECTIVE
  The objective of the study was to test whether ultrasound-measured fetal adrenal gland volume (AGV) and fetal zone enlargement (FZE) predicts preterm birth (PTB) better than cervical length (CL).
  
  
  METHODS
  Three-dimensional and 2-dimensional ultrasound were used prospectively to measure fetal AGV, FZE, and CL in women with preterm labor symptoms. We corrected AGV for fetal weight (cAGV). The ratio between whole gland depth (D) and central fetal zone depth (d) (d/D) was used to measure FZE. Ability of cAGV, d/D, and CL to predict PTB 7 days or less was compared.
  
  
  RESULTS
  Twenty-seven of 74 women (36.5%) presenting between 21 and 34 weeks had PTB of 7 days or less. FZE greater than 49.5% was the single best predictor for PTB (sensitivity/specificity 100%/89%) compared with cAGV (81%/87%) and CL (56%/60%; P < .05). Prediction was independent of obstetrics history and tocolytic use.
  
  
  CONCLUSIONS
  The 2-dimensional measurement of the adrenal gland FZE is highly effective performing superior to CL in identifying women at risk for PTB within 7 days.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA. sifa_ozhan@hotmail.com
authors.forename: Ozhan M
authors.initials: OM
authors.lastname: Turan
authors.forename: Sifa
authors.initials: S
authors.lastname: Turan
authors.forename: Edmund F
authors.initials: EF
authors.lastname: Funai
authors.forename: Irina A
authors.initials: IA
authors.lastname: Buhimschi
authors.forename: Catherine H
authors.initials: CH
authors.lastname: Campbell
authors.forename: Ozan M
authors.initials: OM
authors.lastname: Bahtiyar
authors.forename: Chris R
authors.initials: CR
authors.lastname: Harman
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Copel
authors.forename: Catalin S
authors.initials: CS
authors.lastname: Buhimschi
authors.forename: Ahmet A
authors.initials: AA
authors.lastname: Baschat
mesh_terms: D000311:Adrenal Glands / Q000000981:diagnostic imaging*; D000328:Adult; D054791:Cervical Length Measurement; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D009929:Organ Size; D011247:Pregnancy; D047928:Premature Birth; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal