Startseite Evaluation of fetal middle adrenal artery Doppler and fetal adrenal gland size in pregnancies with fetal growth restriction: a case-control study
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Evaluation of fetal middle adrenal artery Doppler and fetal adrenal gland size in pregnancies with fetal growth restriction: a case-control study

  • Derya Uyan Hendem ORCID logo EMAIL logo , Fatma Doga Ocal , Deniz Oluklu , Berhan Besimoglu , Selcan Sinaci ORCID logo , Aysegul Atalay , Dilek Menekse Beser , Atakan Tanacan ORCID logo und Dilek Sahin
Veröffentlicht/Copyright: 31. August 2022
Journal of Perinatal Medicine
Aus der Zeitschrift Journal of Perinatal Medicine Band 51 Heft 4

Abstract

Objectives

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.

Methods

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.

Results

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).

Conclusions

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.

Keywords: adrenal artery; adrenal gland; fetal growth restriction
Corresponding author: Derya Uyan Hendem, MD, Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health, Ankara City Hospital, 1604th Street, No: 9, Cankaya/Ankara, 06800, Ankara, Turkey, Phone: +905308813182, E-mail:

Acknowledgments

We would like to thank all the health personnel.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. 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 (E2-21-230).

  6. Data availability: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

1. Obstetricians ACo, Gynecologists. ACOG practice bulletin no. 204: fetal growth restriction. Obstet Gynecol 2019;133:e97–109.10.1097/AOG.0000000000003070Suche in Google Scholar PubMed

2. Melau, C, Nielsen, JE, Frederiksen, H, Kilcoyne, K, Perlman, S, Lundvall, L, et al.. Characterization of human adrenal steroidogenesis during fetal development. JCEM 2019;104:1802–12. https://doi.org/10.1210/jc.2018-01759.Suche in Google Scholar PubMed PubMed Central

3. Busada, JT, Cidlowski, JA. Mechanisms of glucocorticoid action during development. Curr Top Dev Biol 2017;125:147–70.10.1016/bs.ctdb.2016.12.004Suche in Google Scholar PubMed

4. Tekay, A, Jouppila, P. Fetal adrenal artery velocimetry measurements in appropriate-for-gestational age and intrauterine growth-restricted fetuses. Ultrasound Obstet Gynecol 2000;16:419–24. https://doi.org/10.1046/j.1469-0705.2000.00222.x.Suche in Google Scholar PubMed

5. Figueras, F, Gratacós, E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther 2014;36:86–98. https://doi.org/10.1159/000357592.Suche in Google Scholar PubMed

6. Gordijn, SJ, Beune, IM, Thilaganathan, B, Papageorghiou, A, Baschat, AA, Baker, PN, et al.. Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound Obstet Gynecol 2016;48:333–9. https://doi.org/10.1002/uog.15884.Suche in Google Scholar PubMed

7. Root, B, Abrassart, J, Myers, DA, Monau, T, Ducsay, CA. Expression and distribution of glucocorticoid receptors in the ovine fetal adrenal cortex: effect of long-term hypoxia. J Basic Clin Reprod Sci. 2008;15:517–28. https://doi.org/10.1177/1933719107311782.Suche in Google Scholar PubMed

8. Bibeau, K, Battista, MC, Houde, V, Brochu, M. Fetal adrenal gland alterations in a rat model of adverse intrauterine environment. Am J Physiol Regul Integr Comp Physiol 2010;298:R899–911. https://doi.org/10.1152/ajpregu.00238.2009.Suche in Google Scholar PubMed

9. Mari, G, Uerpairojkit, B, Abuhamad, AZ, Copel, JA. Adrenal artery velocity waveforms in the appropriate and small-for-gestational-age fetus. Ultrasound Obstet Gynecol 1996;8:82–6. https://doi.org/10.1046/j.1469-0705.1996.08020082.x.Suche in Google Scholar PubMed

10. Farzad Mohajeri, Z, Aalipour, S, Sheikh, M, Shafaat, M, Hantoushzadeh, S, Borna, S, et al.. Ultrasound measurement of fetal adrenal gland in fetuses with intrauterine growth restriction, an early predictive method for adverse outcomes. J Matern Fetal Neonatal Med 2019;32:1485–91. https://doi.org/10.1080/14767058.2017.1410125.Suche in Google Scholar PubMed

11. Heese, S, Hammer, K, Möllers, M, Köster, HA, Falkenberg, MK, Eveslage, M, et al.. Adrenal gland size in growth restricted fetuses. J Perinat Med 2018;46:900–4. https://doi.org/10.1515/jpm-2017-0339.Suche in Google Scholar PubMed

12. Kaya, B, Polat, İ. The investigation of fetal adrenal gland sizes in the pregnancies complicated with the intrauterine growth restriction. J Perinat 2019;27:176–82. https://doi.org/10.2399/prn.19.0273009.Suche in Google Scholar

13. Savchev, S, Figueras, F, Sanz-Cortes, M, Cruz-Lemini, M, Triunfo, S, Botet, F, et al.. Evaluation of an optimal gestational age cut-off for the definition of early – and late-onset fetal growth restriction. Fetal Diagn Ther 2014;36:99–105. https://doi.org/10.1159/000355525.Suche in Google Scholar PubMed

Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2022-0270).

Received: 2022-06-07
Accepted: 2022-07-05
Published Online: 2022-08-31
Published in Print: 2023-05-25

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Reviews
  3. Placenta Accreta Spectrum Part I: anesthesia considerations based on an extended review of the literature
  4. Placenta Accreta Spectrum Part II: hemostatic considerations based on an extended review of the literature
  5. Corner of Academy
  6. The impact of lateral placenta on preeclampsia and small for gestational age neonates: a systematic review and meta-analysis
  7. Original Articles – Obstetrics
  8. Fetal intelligent navigation echocardiography (FINE) has superior performance compared to manual navigation of the fetal heart by non-expert sonologists
  9. Evaluation of fetal middle adrenal artery Doppler and fetal adrenal gland size in pregnancies with fetal growth restriction: a case-control study
  10. First trimester low maternal serum pregnancy associated plasma protein-A (PAPP-A) as a screening method for adverse pregnancy outcomes
  11. Time interval to delivery in asymptomatic twin pregnancies with a short cervix at 23–28 weeks’ gestation
  12. Hepatic arterial buffer response in monochorionic diamniotic pregnancies with twin-to-twin transfusion syndrome
  13. Healthcare of pregnant women with diabetes during the COVID-19 pandemic: a Southern Brazilian cross-sectional panel data
  14. Attitudes toward COVID-19 vaccination of pregnant and lactating women in Hungary
  15. Maternal vitamin D levels correlate with fetal weight and bone metabolism during pregnancy: a materno-neonatal analysis of bone metabolism parameters
  16. Removal of pregnancy categories and likelihood of prescribing: a randomized trial
  17. Prenatal prediction of Shone’s complex. The role of the degree of ventricular disproportion and speckle-tracking analysis
  18. Original Article – Fetus
  19. The effect of middle cerebral artery peak systolic velocity on prognosis in early and late-onset fetal growth restriction
  20. Original Articles – Neonates
  21. Assessment of salivary cortisol concentrations for procedural pain monitoring in newborns
  22. Impact on neonatal morbidities after a change in policy to administer antenatal corticosteroids to mothers at risk for late preterm delivery
  23. The Apgar score in clinical research: for what, how and by whom it is used
  24. Short Communication
  25. Visitor restriction during the COVID-19 pandemic did not impact rates of Staphylococcus aureus colonization in the NICU patients
  26. Letter to the Editor
  27. Knowledge and attitudes of pregnant women on maternal immunization against COVID-19: correspondence
https://doi.org/10.1515/jpm-2022-0270
Schlagwörter für diesen Artikel
adrenal artery; adrenal gland; fetal growth restriction

Artikel in diesem Heft

  1. Frontmatter
  2. Reviews
  3. Placenta Accreta Spectrum Part I: anesthesia considerations based on an extended review of the literature
  4. Placenta Accreta Spectrum Part II: hemostatic considerations based on an extended review of the literature
  5. Corner of Academy
  6. The impact of lateral placenta on preeclampsia and small for gestational age neonates: a systematic review and meta-analysis
  7. Original Articles – Obstetrics
  8. Fetal intelligent navigation echocardiography (FINE) has superior performance compared to manual navigation of the fetal heart by non-expert sonologists
  9. Evaluation of fetal middle adrenal artery Doppler and fetal adrenal gland size in pregnancies with fetal growth restriction: a case-control study
  10. First trimester low maternal serum pregnancy associated plasma protein-A (PAPP-A) as a screening method for adverse pregnancy outcomes
  11. Time interval to delivery in asymptomatic twin pregnancies with a short cervix at 23–28 weeks’ gestation
  12. Hepatic arterial buffer response in monochorionic diamniotic pregnancies with twin-to-twin transfusion syndrome
  13. Healthcare of pregnant women with diabetes during the COVID-19 pandemic: a Southern Brazilian cross-sectional panel data
  14. Attitudes toward COVID-19 vaccination of pregnant and lactating women in Hungary
  15. Maternal vitamin D levels correlate with fetal weight and bone metabolism during pregnancy: a materno-neonatal analysis of bone metabolism parameters
  16. Removal of pregnancy categories and likelihood of prescribing: a randomized trial
  17. Prenatal prediction of Shone’s complex. The role of the degree of ventricular disproportion and speckle-tracking analysis
  18. Original Article – Fetus
  19. The effect of middle cerebral artery peak systolic velocity on prognosis in early and late-onset fetal growth restriction
  20. Original Articles – Neonates
  21. Assessment of salivary cortisol concentrations for procedural pain monitoring in newborns
  22. Impact on neonatal morbidities after a change in policy to administer antenatal corticosteroids to mothers at risk for late preterm delivery
  23. The Apgar score in clinical research: for what, how and by whom it is used
  24. Short Communication
  25. Visitor restriction during the COVID-19 pandemic did not impact rates of Staphylococcus aureus colonization in the NICU patients
  26. Letter to the Editor
  27. Knowledge and attitudes of pregnant women on maternal immunization against COVID-19: correspondence
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