Ultrasonographic identification and measurement of the human fetal adrenal gland in utero: clinical application.

The size of the fetal adrenal gland was determined using ultrasonography in 346 fetuses with no complications at 28-40 weeks of gestation and in 12 fetuses of abnormal pregnancies (8 intrauterine growth retardations, 2 anencephalies, 1 intrauterine fetal death and 1 fetus of a mother who had been on steroids for treatment of systemic lupus erythematosus). The fetal adrenal gland area (FAGA), circumference (FAGC) and length (FAGL) were calculated. In 12 abnormal fetuses, FAGA values always fell below the mean +/- 2 SD. Deviations from the normal values were seen in 9 out of 12 cases (75%) in FAGC and in 4 out of 12 cases (33.3%) in FAGL. Of these pregnancies, 4 (33.3%) resulted in intrauterine fetal or neonatal death, and 2 neonates (16.6%) had to be admitted to the neonatal intensive care unit. Measurement of the fetal adrenal gland, especially of the FAGA, should be a pertinent diagnostic tool for perinatologists to manage and control high-risk pregnancies.