Journal of clinical ultrasound : JCU · 2026
Altered Fetal Adrenal Gland Morphometry and Middle Adrenal Artery Doppler in Pregnancies With Rheumatoid Arthritis and Ankylosing Spondylitis: A Prospective Case-Control Study.
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Oluklu Deniz, Sahin Dilek
Аннотация
OBJECTIVE: To evaluate fetal adrenal gland (FAG) dimensions and middle adrenal artery (MAA) Doppler parameters in pregnancies complicated by rheumatoid arthritis (RA) and ankylosing spondylitis (AS), collectively termed inflammatory arthritis (IA), compared with healthy controls.
METHODS: This study enrolled 46 singleton pregnancies complicated by IA (22 RA, 24 AS) and 92 healthy controls. FAG dimensions (total adrenal gland [TAG] length, width, height; fetal zone [FZ] length, width, height) were measured in transverse and coronal planes. MAA pulsatility index (PI), peak systolic velocity (PSV), end-diastolic velocity (EDV), and time-averaged maximum velocity (TAmax) were recorded by pulsed-wave Doppler.
RESULTS: Compared with controls, the IAgroup had significantly lower MAA-PI, higher MAA-PSV, and higher MAA-EDV. TAG height, FZ length, and FZ width were all significantly larger in IA. In subgroup analysis, FZ width was larger in RA than in AS. MAA-PI was significantly lower than controls in both RA and AS.
CONCLUSION: Pregnancies with RA or AS demonstrate increased FZ dimensions and altered MAA Doppler parameters, consistent with fetal adrenal adaptation to maternal inflammatory conditions. FZ width and MAA-PI showed the most consistent between-group differences; however, their clinical significance and utility remain to be established.
METHODS: This study enrolled 46 singleton pregnancies complicated by IA (22 RA, 24 AS) and 92 healthy controls. FAG dimensions (total adrenal gland [TAG] length, width, height; fetal zone [FZ] length, width, height) were measured in transverse and coronal planes. MAA pulsatility index (PI), peak systolic velocity (PSV), end-diastolic velocity (EDV), and time-averaged maximum velocity (TAmax) were recorded by pulsed-wave Doppler.
RESULTS: Compared with controls, the IAgroup had significantly lower MAA-PI, higher MAA-PSV, and higher MAA-EDV. TAG height, FZ length, and FZ width were all significantly larger in IA. In subgroup analysis, FZ width was larger in RA than in AS. MAA-PI was significantly lower than controls in both RA and AS.
CONCLUSION: Pregnancies with RA or AS demonstrate increased FZ dimensions and altered MAA Doppler parameters, consistent with fetal adrenal adaptation to maternal inflammatory conditions. FZ width and MAA-PI showed the most consistent between-group differences; however, their clinical significance and utility remain to be established.