Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Am J Obstet Gynecol. 2011 Apr;204(4):311.e1-10. doi: 10.1016/j.ajog.2010.11.034. Epub 2011 Feb 3.
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).
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.
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.
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.
本研究旨在测试超声测量胎儿肾上腺体积（AGV）和胎儿区增大（FZE）是否比宫颈长度（CL）更能预测早产（PTB）。
对有早产症状的女性进行前瞻性三维和二维超声检查，以测量胎儿 AGV、FZE 和 CL。我们对胎儿体重进行了 AGV 校正（cAGV）。使用整个腺体深度（D）与中央胎儿区深度（d）的比值（d/D）来测量 FZE。比较 cAGV、d/D 和 CL 预测 7 天或更短时间内 PTB 的能力。
21 周至 34 周之间出现早产症状的 74 名女性中有 27 名（36.5%）在 7 天内分娩。与 cAGV（81%/87%）和 CL（56%/60%；P<.05）相比，FZE 大于 49.5%是预测 PTB 的唯一最佳指标（灵敏度/特异性 100%/89%）。预测与产科病史和保胎治疗无关。
二维测量肾上腺区 FZE 是一种非常有效的方法，在识别 7 天内有 PTB 风险的女性方面优于 CL。
