Fetal adrenal gland size and umbilical artery Doppler in growth-restricted fetuses

Kathrin Oelmeier; Mareike Möllers; Helen A. Köster; Daniela Willy; Eike Bormann; Janina Braun; Walter Klockenbusch; Ralf Schmitz

doi:10.1515/jpm-2022-0203

Article

Fetal adrenal gland size and umbilical artery Doppler in growth-restricted fetuses

Kathrin Oelmeier , Mareike Möllers , Helen A. Köster , Daniela Willy , Eike Bormann , Janina Braun , Walter Klockenbusch and Ralf Schmitz

Published/Copyright: August 15, 2022

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From the journal Journal of Perinatal Medicine Volume 51 Issue 3

Abstract

Objectives

In fetal growth restriction (FGR), Doppler ultrasound is the most important method for the detection and management. However, additional parameters are needed to improve the distinction between constitutionally small fetuses and fetuses affected by FGR.

Methods

A total of 445 singleton pregnancies between 23 and 40 weeks of gestation were included in our retrospective study, of which 67 with FGR and 378 normal fetuses. A 2D-plane of the fetal adrenal gland was obtained and the adrenal gland ratio was measured. Spearman’s correlation coefficient was calculated to assess the association of fetal Doppler and adrenal gland ratio with outcome parameters. Logistic regression analysis was performed to assess the statistical significance of “PI of the umbilical artery” and “adrenal gland ratio” as prognostic factors for intrauterine growth restriction (IUGR).

Results

PI of the umbilical artery was shown to correlate with outcome parameters (WG_Delivery: r=−0.125, p=0.008; birth weight: r=−0.268, p<0.001; birth weight centile: r=−0.248, p<0.001; APGAR at 5 min: r=−0.117, p=0.014). Adrenal gland ratio showed no correlation with any of the outcome parameters. In logistic regression however, both PI of the umbilical artery and the adrenal ratio were shown to be significantly associated with fetal IUGR. When combining the two parameters, predictive value was superior to the predictive value of each individual parameter (AUC 0.738 [95% CI 0.670; 0.806]).

Conclusions

The adrenal gland ratio can be a useful addition to Doppler ultrasound when it comes to the detection of fetal FGR. Prospective studies are needed to establish references ranges and cut-off values for clinical decision-making.

Keywords: adrenal gland ratio; Doppler ultrasound; fetal IUGR; fetal organ mapping

Corresponding author: Dr. med. Kathrin Oelmeier, Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany, Phone: +49 251 83 48212, Fax: +49 2518348210, E-mail: kathrin.oelmeier@ukmuenster.de

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ Institutional Review Board.

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Received: 2022-04-28

Accepted: 2022-07-20

Published Online: 2022-08-15

Published in Print: 2023-03-28

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Articles in the same Issue

https://doi.org/10.1515/jpm-2022-0203

Keywords for this article

adrenal gland ratio; Doppler ultrasound; fetal IUGR; fetal organ mapping