Agarwal Shubhra, Agarwal Arjit, Joon Pawan, Saraswat Shalini, Chandak Shruti
1Department of Obstetrics & Gynecology, Teerthanker Mahaveer Medical College and Research Centre, Teerthanker Mahaveer University, Moradabad, India.
2Department of Radiodiagnosis, Teerthanker Mahaveer Medical College and Research Centre, Teerthanker Mahaveer University, Moradabad, India.
Ultrasound. 2018 Feb;26(1):54-62. doi: 10.1177/1742271X17748515. Epub 2018 Feb 7.
Preterm birth is a major health problem in developing and developed countries leading to rising health care costs and long-term neurodevelopmental disability. The study aims to evaluate the role of new quantitative markers, like the elastography of cervix (shear wave speed estimation), fetal adrenal zone enlargement, and corrected fetal adrenal gland volume; in preterm birth prediction and analyze their relative importance. Thus, these markers may be beneficial in early preterm birth detection and prevent the related morbidities.
Thirty pregnant females (from 28 to 37 weeks of gestational age), showing clinical signs and delivery outcome of preterm birth were included in the study with an equal number of not-in-labor antenatal females at ≥37 weeks as controls. These patients were categorized as preterm and term groups. Both the groups were subjected to trans-abdominal ultrasonography where cervical length, cervical shear wave speed (dynamic elastography) and fetal adrenal gland parameters were measured.
Shear wave speed estimation of the antenatal cervix showed the highest sensitivity and specificity (96.7% and 87% respectively) in the prediction of preterm birth and also showed a strong correlation with fetal adrenal gland enlargement. Fetal adrenal zone enlargement was also shown to be a reliable marker of preterm birth, however, with reduced sensitivity and specificity than shear wave speed.
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.
早产在发达国家和发展中国家都是一个主要的健康问题，导致医疗保健成本上升和长期神经发育残疾。本研究旨在评估新的定量标志物的作用，如宫颈弹性成像（剪切波速度估计）、胎儿肾上腺区增大和校正后的胎儿肾上腺体积；在早产预测中的作用，并分析它们的相对重要性。因此，这些标志物可能有助于早期早产检测并预防相关疾病。
30名妊娠女性（孕龄28至37周），表现出早产的临床体征和分娩结局，被纳入研究，同时纳入同等数量的孕37周及以上未临产的产前女性作为对照。这些患者被分为早产组和足月组。两组均接受经腹超声检查，测量宫颈长度、宫颈剪切波速度（动态弹性成像）和胎儿肾上腺参数。
产前宫颈剪切波速度估计在早产预测中显示出最高的敏感性和特异性（分别为96.7%和87%），并且与胎儿肾上腺增大也有很强的相关性。胎儿肾上腺区增大也被证明是早产的可靠标志物，然而，其敏感性和特异性低于剪切波速度。
弹性成像技术进步和胎儿肾上腺生物测量得出的定量标志物可作为准确预测早产的客观和标准标准。
