الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Preterm birth (PTB) remains a major cause of perinatal morbidity and mortality worldwide. Compared with term deliveries, early PTB (<34 weeks’ gestation) carries a 7-fold increased risk of neonatal death. Following PTB, survivors can experience significant long-term cognitive, behavioral, emotional, sensory, and motor deficits. Thus, identification of women at risk for PTB is one of the critical prerequisites for effective intervention and improvement in outcome. For the last several decades, significant effort has been focused toward discovery of an accurate method to predict PTB. Traditional predictors such as obstetric risk factors and clinical presentation are helpful but seldom completely define the population that will truly deliver preterm (88). Aim of the work is to detect the role of ultrasound assessment of fetal adrenal gland measurements in prediction of preterm labour. The study will be carried out on 66 patients. Thirty three preterm pregnant women at 29-36 weeks of gestation with single pregnancy admitted to the hospital with the clinical diagnosis of preterm labor. On the other hand, a comparison group of 33 pregnant women between 37 and 40 weeks with term pregnancy was included in this study. Before the study, the written consent form was received from the hospitals following the reception of the required approval of the ethics committee of the hospital.
Placenta previa, diabetes mellitus, gestational diabetes, maternal heart disease, Hypertensive disorders, abruption placenta, multiple pregnancies, polyhydramnios, oligohydramnios, existence of
Summary 83
anemia, fetal distress, FGR, stillborn fetuses, fetal abnormality incompatible with life were specified as exclusion criteria for participation in the study.
the existence of regular, effective (45-50 mmHg) uterine contractions, 4 in 20 minutes or 6 in 60 minutes, cervical dilatation of ≥2 cm or the existence of a cervical change during observations, premature rupture of membranes were detected through sterile speculum examination were specified as Inclusion criteria for participation in the study. The entire pregnant women undergoing systemic and obstetric examination were initially assessed by routine trans abdominal ultrasonography (3.5 MHz convex abdominal prob, LOGIQ V series S/W function). During ultrasonography, fetal biometric measurements were performed; fetal weight has been calculated and the relevant gestational ages were verified. Fetal adrenal gland was assessed.
We found no difference was found between the two groups in respect of age and number of pregnancies (P > 0.05); yet preterm birth history, rupture of membrane, cervical dilatation and mode of delivery were higher in preterm group (P <0.05).
Of the women evaluated in this study, 27 deliverd preterm, 7 (24.1%) had history of PTL, 17 (58.6%) had PROM. Regarding the mode of delivery: 14 (48.3%) was vaginal and 15 (51.7%) was caesarean. Fetal adrenal gland FZD/TGD ratio was statistically significantly higher in preterm group compared to the term group (52% ± 5% vs. 29% ± 9%; P < 0.001.There is a direct positive relationship between cervical dilatation and preterm labor.There is a direct positive relationship between increase FZD that lead to increase FZD/TGD Ratio in patient undergoing preterm delivery.