P5361Pregnancy in patients with cardiac arrhythmias

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Kirgizova ◽  
A Dedkova ◽  
I Kisteneva ◽  
E Borisova
Keyword(s):  
Pregnant Women ◽  
Cardiac Arrhythmias ◽  
Radiation Risk ◽  
Pacemaker Implantation ◽  
Preterm Births ◽  
Block Type ◽  
Type Ii ◽  
Av Block ◽  
Female Population ◽  
Premature Beats

Abstract Introduction Negative trends in the state of somatic and reproductive health of the female population are observed in the last decades all over the world. On the background of declining birth rates, the problems of managing pregnancy in women with extragenital pathology become relevant. Aim To study the effects of cardiac arrhythmias and antiarrhythmic treatment on the course and outcomes of pregnancy. Material and methods A total of 55 case histories of pregnant women hospitalized in the Department of Interventional Arrhythmology. All patients signed informed consent to be enrolled in the study. The age of patients ranged from 17 to 41 years (mean age of 30.2±4.0 years). Patients were hospitalized on average at 28.0±6.4 weeks of gestation (from 12 to 37 weeks) and had some form of cardiac arrhythmia. Results Cardiac arrhythmias were idiopathic in 65% of cases; the rest of patients had verified cardiovascular diseases. Cardiac arrhythmias were registered in 41 (74%) of women prior to pregnancy and their arrhythmological history lasted for 7.9±1.1 years. Extrasystolic arrhythmia was the most common type of cardiac arrhythmias: ventricular premature beats occurred in 23 pregnant women (42%) including supraventricular premature beats in 8 patients (14%), supraventricular tachycardia in 12 patients (22%), and ventricular tachycardia (VT) in 5 women (9%). In three cases, VTs were hemodynamically significant. Radiofrequency ablation (RFA) of VT was performed in pregnant women at 26, 27, and 32 weeks of gestation. Five patients with gestational ages of 27–34 weeks received RFA for atrial tachycardia and atrioventricular (AV) reciprocal tachycardia to treat symptomatic intracardiac tachycardia (n=4) and continuous recurrent AV nodal tachycardia (n=1), paroxysms of which were accompanied by destabilization of hemodynamics. AV block was registered in 4 pregnant women (9%); sick sinus syndrome was diagnosed in 1 patient (2%). Implantation of pacemaker was required in 1 case for a second-degree AV block type II (Mobitz type II) at 24 weeks of pregnancy. RFA and pacemaker implantation were carried out with minimal or zero fluoroscopy and only after the 22nd week of pregnancy, that is, without or with reduced radiation risk to the fetus. 16 patients (29%) had cesarean section; the rest of patients had spontaneous vaginal delivery. The average Apgar scores were 8.64 immediately after birth and 9.35 five minutes after birth. Preterm births (n=2) were due to obstetric pathology and were not associated with cardiac arrhythmias. Cardiac arrhythmias were not observed in any patient in childbirth. Conclusions Cardiac arrhythmias, observed in patients, did not require termination of pregnancy. Catheter ablation for symptomatic, hemodynamically significant, and life-threatening cardiac arrhythmias made it possible to effectively guide pregnant women to delivery with a close follow-up.

scholarly journals Cardiac arrhythmias 3 months after hospitalization for COVID-19

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C B Ingul ◽  
J Grimsmo ◽  
A Mecinaj ◽  
D Trebinjac ◽  
M Berger Nossen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Cardiac Arrhythmia ◽  
Cardiac Arrhythmias ◽  
Troponin T ◽  
Public Institution ◽  
Block Type ◽  
Av Block ◽  
Premature Ventricular Contractions ◽  
Increased Risk

Abstract Background The long-term frequencies of cardiac arrhythmias in hospitalized coronavirus disease 2019 (COVID-19) patients have not been thoroughly investigated. Purpose To describe the prevalence of cardiac arrhythmias, 3–4 months after hospitalization for COVID-19. Methods and results Participants with COVID-19 discharged from five large Norwegian hospitals were invited to participate in a prospective cohort study. We examined 201 participants (44% females, mean age 58.5 years) with 24-hour electrocardiogram 3–4 months after discharge. Body mass index (BMI) was 28.3±4.5 kg/m2 (mean ± SD), and obesity (BMI >30) was found in 70 participants (34%). Clinically significant arrhythmias were defined as; ventricular tachycardia (non-sustained or sustained), premature ventricular contractions (PVC) exceeding 200/24 h, or coupled PVC, atrial fibrillation/flutter, second-degree atrioventricular block (AV-block) type 2, complete AV-block, sinoatrial (SA) block exceeding 3 s, premature AV-nodal beats in bigeminy, supraventricular tachycardia (SVT) exceeding 30 s, and sinus bradycardia with less than 30 beats/min. High-sensitive cardiac troponin T (hs-cTnT) was measured at the 3-month follow-up. Results Cardiac arrhythmias were found in 27% (n=54) of the participants. Ventricular premature contractions and non-sustained ventricular tachycardia were the most common arrhythmias, found in 22% (n=44) of the participants. Premature ventricular contractions were the most frequent cardiac arrhythmia. More than 200 PVCs per day were observed in 37 participants (18%) with a mean of 1300 PVC/day, and in 35 (95%) of these participants, the PVCs were polymorphic. Among 10 patients experiencing NSVT, 5 participants had previous CVD, including coronary heart disease (n=1), 1 atrial fibrillation, 2 venous thromboembolism, 4 heart failure. Atrial fibrillation was found in seven patients (3%), none of them of new-onset. SA block >3 seconds was only observed in one patient, and no incidence of high degree AV block was discovered. Pre-existing cardiovascular disease or hypertension (CVDH) were reported in 40% (n=81) of the participants. The CVDH group had an increased amount of arrhythmia compared to the group free of CVDH (p=0.04). High PVCs showed a fair correlation with hs-cTnT levels at 3 months (ρ=0.21 p=0.048). Conclusions Three months following hospital discharge with COVID-19, cardiac arrhythmia was found in every fourth participant and was associated with a higher concentration of hs-cTnT at 3 months. The clinical implications of persistent ventricular arrhythmia following COVID-19 is not clear, but ventricular ectopy has been linked to increased risk of cardiac disease, including cardiomyopathy and sudden cardiac death. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): The National Association for Heart, Lung diseases and the Norwegian Health Association and Akershus University Hospital.

Pre-existent 1st degree AV-Block before TAVI with Sapien 3 – is prolonged monitoring required?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F De Torres Alba ◽  
G Kaleschke ◽  
J Vormbrock ◽  
H Reinecke ◽  
H Deschka ◽  
...  
Keyword(s):  
Pacemaker Implantation ◽  
High Grade ◽  
Av Block ◽  
Multivariable Logistic Regression Model ◽  
Consensus Document ◽  
Risk Patients ◽  
Valve In Valve ◽  
Prolonged Monitoring ◽  
Sapien 3 ◽  
Expert Consensus Document

Abstract Introduction Pre-existing right bundle branch block (RBBB) is a well stablished risk factor for the development of high grade conduction abnormalities (CAs) after TAVI. The association of pre-existing 1st degree AV-Block (AVB1) with high grade CAs after TAVI has been inconsistent. A recently published Expert Consensus Document classifies patients with AVB1 in the lowest risk group, allowing for discharge at day 1 post-TAVI. We aimed to study the risk of these patients of developing delayed high grade CAs requiring pacemaker implantation (PM). Methods We studied the development CAs in 1447 consecutive patients treated with Sapien 3 between January 2014 and December 2019. After excluding valve-in-valve procedures (n=30) and pts with previously implanted PM (n=167) 1254 patients remained for analysis. All patients were monitored for at least 7 days, as this was our institutional policy during the study period. We analyzed if pre-existing ECG abnormalities predict early and delayed (>24h) high grade CAs with a multivariable logistic regression model. Results Of 1254 pts, 159 (12.5%) required a permanent PM after TAVI. In 104 (65%) CAs requiring PM occurred intraprocedural or during the first 48h while in the remaining 35% developed with more delay. We analyzed the presence of previous CAs in pts still free from indication for PM after the first 48h after TAVI (n=1150) in order to identify characteristics that may predict delayed PM requirement (Table). In the multivariable model not only RBBB (OR 5.42, CI95% 2.69–10.94, p<0.0001) but also AVB1 was significantly associated to delayed high grade CAs requiring PM implantation (OR 2.25, CI95% 1.24–4.08, p=0.005). Conclusion In this study, in pts requiring PM implantation after TAVI, the high grade CAs occurred after 48h in 35% of patients. Not only RBBB but also AVB1 was an independent predictor of delayed high grade CAs. These results question the safety of considering patients with pre-existing AVB1 as low-risk patients and suggest a more prolonged monitoring also for them. Funding Acknowledgement Type of funding source: None

scholarly journals Pregnancy Outcomes and SARS-CoV-2 Infection: The Spanish Obstetric Emergency Group Study

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 853
Author(s):  
Sara Cruz Melguizo ◽  
María Luisa de la Cruz Conty ◽  
Paola Carmona Payán ◽  
Alejandra Abascal-Saiz ◽  
Pilar Pintando Recarte ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Preterm Births ◽  
Hypertensive Disorder ◽  
Obstetric Emergency ◽  
Increased Risk ◽  
Emergency Group ◽  
Adverse Perinatal Outcomes ◽  
Maternal Disease ◽  
The Relationship

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).

scholarly journals Role of antenatal plasma cytomegalovirus DNA levels on pregnancy outcome and HIV-1 vertical transmission among mothers in the University of Zimbabwe birth cohort study (UZBCS)

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Kerina Duri ◽  
◽  
Simbarashe Chimhuya ◽  
Exnevia Gomo ◽  
Privilege Tendai Munjoma ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Vertical Transmission ◽  
Pregnancy Outcomes ◽  
Preterm Births ◽  
Multivariate Logistic Regression Model ◽  
Birth Cohort Study ◽  
Childhood Disability ◽  
Hiv 1 ◽  
Cmv Dnaemia ◽  
Rna Levels

Introduction Despite being a leading infectious cause of childhood disability globally, testing for cytomegalovirus (CMV) infections in pregnancy is generally not done in Sub-Sahara Africa (SSA), where breastfeeding practice is almost universal. Whilst CMV and human immunodeficiency virus (HIV) are both endemic in SSA, the relationship between antenatal plasma CMV-DNA, HIV-1-RNA levels and HIV-1-mother to child transmission (MTCT) including pregnancy outcomes remains poorly described. Methods Pregnant women at least 20 weeks’ gestational age at enrolment were recruited from relatively poor high-density suburbs in Harare, Zimbabwe. Mother-infant dyads were followed up until 6 months postpartum. In a case–control study design, we tested antenatal plasma CMV-DNA levels in all 11 HIV-1 transmitting mothers, as well as randomly selected HIV-infected but non-transmitting mothers and HIV-uninfected controls. CMV-DNA was detected and quantified using polymerase chain reaction (PCR) technique. Antenatal plasma HIV-1-RNA load was quantified by reverse transcriptase PCR. Infants’ HIV-1 infection was detected using qualitative proviral DNA-PCR. Predictive value of antenatal plasma CMV-DNAemia (CMV-DNA of > 50 copies/mL) for HIV-1-MTCT was analyzed in univariate and multivariate regression analyses. Associations of CMV-DNAemia with HIV-1-RNA levels and pregnancy outcomes were also explored. Results CMV-DNAemia data were available for 11 HIV-1 transmitting mothers, 120 HIV-infected but non-transmitting controls and 46 HIV-uninfected mothers. In a multivariate logistic regression model, we found a significant association between CMV-DNAemia of > 50 copies/mL and HIV-1 vertical transmission (p = 0.035). There was no difference in frequencies of detectable CMV-DNAemia between HIV-infected and -uninfected pregnant women (p = 0.841). However, CMV-DNA levels were higher in immunosuppressed HIV-infected pregnant women, CD4 < 200 cells/µL (p = 0.018). Non-significant associations of more preterm births (< 37 weeks, p = 0.063), and generally lower birth weights (< 2500 g, p = 0.450) were observed in infants born of HIV-infected mothers with CMV-DNAemia. Furthermore, in a multivariate analysis of HIV-infected but non-transmitting mothers, CMV-DNAemia of > 50 copies/mL correlated significantly with antenatal plasma HIV-1-RNA load (p = 0.002). Conclusion Antenatal plasma CMV-DNA of > 50 copies/mL may be an independent risk factor for HIV-1-MTCT and higher plasma HIV-1-RNA load, raising the possibility that controlling antenatal CMV-DNAemia might improve infant health outcomes. Further studies with larger sample sizes are warranted to confirm our findings.

Anatomical predictors of high grade atrioventricular conduction disorders in patients with specific pacemaker implanted after TAVI

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
P Frey ◽  
A Brochier ◽  
N Nezzouhairi ◽  
D Irles
Keyword(s):  
Atrioventricular Block ◽  
Pacemaker Implantation ◽  
Atrioventricular Conduction ◽  
High Grade ◽  
Av Block ◽  
Conduction Disorders ◽  
Transcatheter Aortic Valve ◽  
The Difference ◽  
Valve Implantation ◽  
Membranous Septum

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf STIM TAVI-MS study Background  The evolution of atrioventricular conduction disorders after transcatheter aortic valve implantation (TAVI) remains poorly understood. Recent studies have identified short membranous septum (MS) length, deep implantation depth (ID) or their relation as anatomic risk of high-grade AV block and permanent pacemaker implantation. Purpose : We sought to examine whether the atrioventricular (AV) membranous septum (MS) measured by computed tomography (CT) and the depth of valve implantation measured from the final aortic angiogram could predict high-grade atrioventricular block (HG AVB) after TAVI, based on specific pacemaker memory data. Methods STIM-TAVI-MS was a prospective, multicentre observational study that enrolled patients implanted with a specific dual chamber pacemaker after TAVI, with the SafeR algorithm activated, allowing continuous monitoring of atrioventricular conduction. The primary endpoint was the occurrence of late (after Day 7) high-grade atrioventricular block(s) during the year after TAVI. We measured on CT scans the coronal MS lenght, infra-annular MS lenght and the quantification of calcifications, on the final angiogram after TAVI we measured the implant depth (ID) to identifie ΔID-MS corresponding to the difference between implant depth and MS length. The variables were compared with the occurrence of late HG-AVB on PM memory data. Results : Among 82 patients, (mean age 84,5 years ± 4,8, self-expending valve n = 24, 29,3%), n = 47 (57.3%) had ≥1 late high-grade atrioventricular block. Mean coronal MS length was 8,1 ± 2,5 mm, mean infra annular MS was 3,4 ± 3.1 mm, mean calcification volume was 93.0 ± 88, 85,5± 104 and 141,5 ± 137,5 mm3 for the noncoronary, right coronary and left coronary cusp respectively. Mean implant depth was 7,3 ± 3,3mm, and mean ΔID-MS = -0,7 ± 4,1mm. There were no association between MS length (OR = 1,06; CI 0,91 to 1,24), ID (OR = 1,6; CI 0,85 to 2,9), nor ΔID-MS (OR = 0,67; CI 0,37 to 1,23) and late HG AVB. Calcification volume were not associated with late HG AVB. Conclusion In an high risk high grade AV block population after TAVI, anatomical analysis of MS length, degree of calcification, implant depth and ΔID-MS did not predict occurrence of late (&gt; day 7 after TAVI ) high grade AV Blocks. Abstract Figure. CT scan A : aortic plane, B : MS lenght

scholarly journals Smoking during pregnancy in Finland – Trends in the MATEX cohort

2018 ◽  
Vol 47 (8) ◽  
pp. 890-898 ◽  
Author(s):  
Isabell K. Rumrich ◽  
Kirsi Vähäkangas ◽  
Matti Viluksela ◽  
Mika Gissler ◽  
Heljä-Marja Surcel ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Young Women ◽  
Trigger Point ◽  
Age Groups ◽  
Smoking Behaviour ◽  
Smoking Rate ◽  
Female Population ◽  
Smoking During Pregnancy ◽  
Spatial Trends ◽  
Eastern Finland

Aims: In Finland, smoking rates in the general population are decreasing due to increased awareness of the adverse effects and tightened tobacco legislation. However, previous studies have shown that smoking in pregnant Finnish women remained as high as in the general Finnish female population at around 15% in 2010. Our aim was to describe temporal and spatial trends in smoking behaviour, and determinants of changes in smoking behaviour between first and second pregnancy. Methods: Self-reported smoking from the Finnish Medical Birth Register covered the years 1991–2015 ( N=1,435,009). The association of maternal age and socioeconomic status with smoking rate was analysed. Spatial trends were assessed at municipality level. Results: The overall smoking rate during early pregnancy remained fairly stable at around 15% from 1991 to 2015, but increased in teenage and young women below 25 years of age. The mean smoking rate (36%) was higher in these age groups than in older pregnant women (11%). Through the study period the smoking rate remained higher in blue collar workers compared with higher socioeconomic groups. Between the first and second child, on average only 4% of women started to smoke and 41% quitted. Smoking rates developed less favourably in Eastern Finland. Conclusions: The observed increase in smoking rate during pregnancy in teenage and young women is concerning. Pregnancy is a trigger point for smoking cessation in a big fraction of pregnant women. More studies are needed to explain the opposite trends of smoking rates in Northern and Western Finland compared with Eastern Finland.

scholarly journals Seroprevalence of toxoplasmosis in Vojvodina

2010 ◽  
Vol 138 (5-6) ◽  
pp. 333-336 ◽  
Author(s):  
Snezana Brkic ◽  
Gorana Gajski ◽  
Mirjana Bogavac ◽  
Daniela Maric ◽  
Vesna Turkulov ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
General Population ◽  
Pregnant Women ◽  
Acute Infection ◽  
Clinical Manifestations ◽  
Congenital Toxoplasmosis ◽  
Reproductive Age ◽  
Female Population ◽  
Effective Measure ◽  
Female Patients

Introduction Toxoplasmosis is an acute infectious anthropozoonotic disease with mild asymptomatic clinical manifestations in immunocompetent persons and more severe in immunocompromised patients. Acute infection in pregnancy can result in severe congenital toxoplasmosis with severe sequels. Objective Aims of study were to detect Toxoplasma gondii seroprevalence in general population of Vojvodina, Serbia, differences between genders and determination of seroprevalence in women of reproductive age and pregnant women. Methods Our retrospective study was conducted from 2006 to 2008 including 625 immunocompetent patients, hospitalized or observed as outpatients at the Clinical Centre of Vojvodina, Novi Sad. We performed commercial ELISA kits SERION - ELISA classic test by VIRION for the presence of specific IgG and IgM antibodies. According to seroepidemiological aim of the study, our results were presented only in qualitative values. Results We observed 173 male and 452 female patients. Seroprevalence in general population of Vojvodina was 38.1%. In male population seroprevalence was 45.7%, and in female population it was 35.2%, the difference which was statistically significant (p<0.05). Seroprevalence increased with age and seroconversion was detected to occur in persons aged about 20 years. In all female patients, 353 (78.1%) were in reproductive age with seroprevalence of 30%. In 161 pregnant women seroprevalence was 31.7%. Conclusion In this study we screened actual seroepidemiological situation to Toxoplasma gondii in Vojvodina, thus giving a contribution to the continuous epidemiological screening done in this region and in the country. According to our results, almost 70% of women in reproductive age were sensitive to primary acute infection during further pregnancies, which is highly important for the prevention of congenital toxoplasmosis. Although not routinely conducted in many countries, routine serological testing to Toxoplasma gondii in pregnant women and their education about preventive measures against this infection could be an effective measure in the future.

scholarly journals Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fahimeh Ranjbar ◽  
Leila Allahqoli ◽  
Soheila Ahmadi ◽  
Robab Mousavi ◽  
Maryam Gharacheh ◽  
...  
Keyword(s):  
Health Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Health Care Services ◽  
Mode Of Delivery ◽  
Preterm Births ◽  
Future Health ◽  
Significant Difference

Abstract Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.

scholarly journals ULTRASOUND ASSESSMENT OF FETALADRENAL GLAND VOLUME (FAGV) AND ADRENAL FETAL ZONE ENLARGEMENT(AFZE):VIABLE AND SUPERIOR ALTERNATIVES TO CERVICAL LENGTH (CL) IN ACCURATE PREDICTION OF PRETERM BIRTHS.

2020 ◽  
pp. 26-28
Author(s):  
Jatin Venugopal Kutnikar ◽  
Saravanan Kannan ◽  
Prabhakaran Maduraimuthu
Keyword(s):  
Adrenal Gland ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Preterm Births ◽  
Cervical Length ◽  
Public Health Issue ◽  
Zone Length ◽  
Gland Volume ◽  
Study Results ◽  
Adrenal Gland Volume

BACKGROUND: Owing to associated neonatal death, morbidity and impairment in later life, preterm birth is a major public health issue. Pregnant ladies presenting to the antenatal clinic were recruited in order to predict spontaneous preterm births bythe novel method of assessing the Fetal Adrenal Gland Volume (FAGV) and Adrenal Fetal ZoneEnlargement(AFZE) and comparing it with Cervical length. MATERIAL AND METHODS:This was a prospective observational study done at a tertiary hospital in Chennai.The formulae,AFZE=Gland length/Central fetal zone length and FAGV=0.523 x length x width x depth. cFAGV=fetal adrenal gland volume/estimated fetal weight =FAGV/EFW, were employed for the purpose of this study.𝛘2 or Fisher’s exact tests,Mann-Whitney or student-t test were calculated for appropriate variables. Pregnant women with uncomplicated pregnancy with gestational age between 21-34 weeks were recruited for this study. RESULTS:70 pregnant women were studied from May2019 to August 2020 and had an average age of 25 years and mean age of gestation being 27.1 weeks.26(37.1%) of these had a preterm delivery of ≤7 days.AFZE emerged as the best predictor among the three metrics with sensitivity of 100% and specificity of ~90 %.cFAGV showed ~80%/~89% sensitivity and specificity.This was in contrast to cervical length of ≤16 mm having just 55% and 60% sensitivity and specificity respectively. SUMMARY:USG estimation of AFZE and cFAGV are more reliable and accurate indicators than CL for spontaneous preterm delivery and can be used in the routine scanning of patients with early symptoms of preterm labour to plan the management more effectively.

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