February 27, 2012
One of the greatest challenges in obstetrics is treating and preventing preterm labor that has an annual cost of 26 billion per year and is the most common reason for birth defects. In past 10 years, measuring length of the cervix has been used a tool to determine whether the patient is high-risk for early labor and delivery. A cervical measurement by an ultrasound of approximately 2.5 centimeters or 1 inch is highly suggestive of impending early labor. However, because there have been many false positive results, it is not recommended for use as a screening test for all pregnant women; only those who have had a history of a previous premature birth.
The quest for finding a tool to predict preterm labor continues and a joint medical study out of the Universities of Maryland and Yale may be onto something according to the American Journal of Obstetrics and Gynecology. They attempted to determine if there are other ways to identify babies that are at risk for early delivery and used an ultrasound to measure fetal adrenal glands. Preliminary results show great promise. The measurement of fetal adrenals was proven to be a predictor of preterm labor. What are the adrenal glands? They sit on top of the kidneys and are responsible for the “fight or flight” responses that the body needs when it is stressed. It speeds up the heart, increases blood pressure and the rate of breathing. An enlargement of the fetal adrenal gland volume with the use of a 2-dimensional ultrasound can identify women who are at risk for having a preterm birth within 7 days. So, for example, if a woman complains of back pain or early contractions, an ultrasound measurement of the fetal adrenals would predict whether she is at risk for developing preterm labor within the next 7 days. Armed with this information, obstetricians and clinicians can give the appropriate treatment in an attempt to prevent early labor. Although this is not the present standard of care it is certainly something to look forward to in the near future.
Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.