Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
Department of Obstetrics and Gynecology, Division of Perinatology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
J Perinat Med. 2022 Aug 31;51(4):492-499. doi: 10.1515/jpm-2022-0270. Print 2023 May 25.
This study aims to evaluate sonographic measurements of fetal adrenal gland size and middle adrenal artery Doppler in pregnancies with fetal growth restriction (FGR) and in a healthy control group.
This prospective study included 107 singleton pregnancies with FGR between 24 and 42 weeks of gestation and 107 pregnancies with fetuses whose growth was appropriate for gestational age (AGA). Adrenal gland size and Doppler parameters of the adrenal artery were measured and the values and obstetric outcomes were compared between the study and control groups.
In the study group, the Z-scores of total adrenal width-length and height, fetal zone width-length and middle adrenal artery-peak systolic velocity (MAA-PSV) were significantly higher than those in the control group (p<0.05). The Z-scores of middle adrenal artery-pulsatility index (MAA-PI) were significantly lower in the study group than in the control group (p<0.05). The rate of neonatal intensive care unit admission in fetuses with high adrenal artery PI scores was higher in the FGR group (p<0.05).
In the present study, we observed decreased adrenal artery PI, increased adrenal blood flow, and increased fetal adrenal volume in fetuses diagnosed with fetal growth restriction, most likely in response to placental insufficiency and chronic hypoxia.
本研究旨在评估胎儿生长受限（FGR）妊娠和健康对照组中胎儿肾上腺大小和肾上腺中动脉多普勒的超声测量值。
本前瞻性研究纳入了 107 例孕 24 至 42 周的单胎 FGR 妊娠和 107 例胎儿生长符合胎龄（AGA）的妊娠。测量了肾上腺大小和肾上腺中动脉的多普勒参数，并比较了研究组和对照组的数值和产科结局。
在研究组中，总肾上腺宽-长径和高径、胎儿区宽-长径和肾上腺中动脉-收缩期峰值速度（MAA-PSV）的 Z 评分明显高于对照组（p<0.05）。研究组的肾上腺中动脉搏动指数（MAA-PI）Z 评分明显低于对照组（p<0.05）。在高肾上腺动脉 PI 评分胎儿中，FGR 组新生儿重症监护病房（NICU）入住率较高（p<0.05）。
本研究观察到胎儿生长受限时肾上腺动脉 PI 降低、肾上腺血流增加和胎儿肾上腺体积增加，这可能是对胎盘功能不全和慢性缺氧的反应。
