title: Delivery prediction in pregnant women with spontaneous preterm birth using fetal adrenal gland biometry.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: a Fetal Medicine Service - Maternidade-Escola Assis Chateaubriand, Federal University of Ceará (UFC) , Fortaleza - CE , Brazil and.
authors.forename: Aline Pinto
authors.initials: AP
authors.lastname: Lemos
authors.affiliation: a Fetal Medicine Service - Maternidade-Escola Assis Chateaubriand, Federal University of Ceará (UFC) , Fortaleza - CE , Brazil and.
authors.forename: Francisco Edson de Lucena
authors.initials: FE
authors.lastname: Feitosa
authors.affiliation: b Department of Obstetrics , Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP) , São Paulo - SP , Brazil.
authors.forename: Edward
authors.initials: E
authors.lastname: Araujo Júnior
authors.affiliation: a Fetal Medicine Service - Maternidade-Escola Assis Chateaubriand, Federal University of Ceará (UFC) , Fortaleza - CE , Brazil and.
authors.forename: Helvécio Neves
authors.initials: HN
authors.lastname: Feitosa
authors.affiliation: a Fetal Medicine Service - Maternidade-Escola Assis Chateaubriand, Federal University of Ceará (UFC) , Fortaleza - CE , Brazil and.
authors.forename: João Gabriel Damasceno
authors.initials: JG
authors.lastname: Pereira
authors.affiliation: a Fetal Medicine Service - Maternidade-Escola Assis Chateaubriand, Federal University of Ceará (UFC) , Fortaleza - CE , Brazil and.
authors.forename: Rosa Maria Salani
authors.initials: RM
authors.lastname: Mota
authors.affiliation: a Fetal Medicine Service - Maternidade-Escola Assis Chateaubriand, Federal University of Ceará (UFC) , Fortaleza - CE , Brazil and.
authors.forename: Francisco Herlânio Costa
authors.initials: FH
authors.lastname: Carvalho
mesh_terms: D000293:Adolescent; D000311:Adrenal Glands / Q000033:anatomy & histology*; D000328:Adult; D001699:Biometry; D054791:Cervical Length Measurement; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D047928:Premature Birth / Q000175:diagnosis*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013997:Time Factors; D055815:Young Adult
keywords: Adrenal gland; cervical length; fetus; preterm birth; ultrasound