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Comparative Study
. 2024 Aug 29:2024:9968509.
doi: 10.1155/2024/9968509. eCollection 2024.

The Impact of Fetal Growth Restriction on Prenatal 2D Ultrasound and Doppler Study of the Fetal Adrenal Gland

Suphawan Pattamathamakul  1 , Chatuporn Duangkum  1 , Sukanya Chaiyarach  1 , Kiattisak Kongwattanakul  1 , Piyamas Saksiriwuttho  1 , Ratana Komwilaisak  1 , Sathida Chantanavilai  2 , Manasicha Pongsamakthai  2 , Prapassara Sirikarn  3
Affiliations
Comparative Study

The Impact of Fetal Growth Restriction on Prenatal 2D Ultrasound and Doppler Study of the Fetal Adrenal Gland

Suphawan Pattamathamakul et al. J Pregnancy. .

Abstract

Background: Uteroplacental insufficiency in fetuses with growth restriction (FGR) leads to chronic hypoxia and stress, predominantly affecting the adrenal glands. However, the mechanisms of impact remain unclear. Objectives: This study is aimed at comparing the Doppler indices of the adrenal artery and the adrenal gland sizes between FGR and those with normal growth. Materials and Methods: A multicenter, cross-sectional study was conducted from February to December 2023. We compared 34 FGR to 34 with normal growth in terms of inferior adrenal artery (IAA) Doppler indices and adrenal gland volumes. Results: The IAA peak systolic velocity (PSV) in the FGR group was 14.9 ± 2.9 cm/s compared to 13.5 ± 2.0 cm/s in the normal group, with a mean difference of 1.4 cm/s (95% confidence interval [CI]: 0.27-2.65; p value = 0.017). There were no significant differences between groups in terms of IAA pulsatility index (PI), resistance index (RI), or systolic/diastolic (S/D), with p values of 0.438, 0.441, and 0.658, respectively. The volumes of the corrected whole adrenal gland and the corrected neocortex were significantly larger in the FGR group, with p values of 0.031 and 0.020, respectively. Conclusion: Both increased IAA PSV and enlarged volumes of the corrected whole adrenal gland and neocortex were found in fetuses with FGR, suggesting significant adrenal gland adaptation in response to chronic intrauterine stress.

Keywords: adrenal artery; fetal adrenal gland; fetal growth restriction; inferior adrenal artery; neocortex.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Two-dimensional fetal adrenal gland ultrasonography. (A) Axial plane: length (1) and width (2) of the WAG and length (3) and width (4) of the FZ. (B) Sagittal plane: depth of the WAG (1) and depth of the FZ (2). Abbreviations: FZ, fetal zone; WAG, whole adrenal gland.
Figure 2
Figure 2
(A) Doppler color flow of IAA in oblique-coronal plane. (B) The IAA Doppler pulse waves and indices. Abbreviations: AG, adrenal gland; Ao, aorta; IAA, inferior adrenal artry; KD, kidney; RA, renal artery.
Figure 3
Figure 3
The study flow of the participants.
See this image and copyright information in PMC

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