The importance of fetal adrenal gland volume measurement in successful labor induction with oxytocin

Aim We aimed to show the predictive value of fetal adrenal gland volume (FAGV) measurement in the success of labor induction with oxytocin. Methods This is a prospective cohort study that included a total of 103 term nulliparous. Immediately after deciding to induce labor with oxytocin, the fetal right and left adrenal gland measurements were obtained. Results Induction success was achieved in 89 of 103 (86.4%) pregnant women. In comparison of the FAGV values of failed induction labor group, the total volumes of right and left fetal adrenal glands and the fetal zone volumes (FZV) were found to be statistically significantly higher in the successful labor induction group (p < 0.001). In predicting induction success, the cut-off value of fetal adrenal gland volume (cFAGV) was set as >230.2 mm(3)/kg and area under curve (AUC) value of 0.872 (95% confidence interval [CI], 0.736-1.000) for right total adrenal gland (p < 0.001). The cut-off value of cFAGV was set as >236.7 mm(3)/kg and AUC value of 0.891(95%CI, 0.768-1.000) (p < 0.001) for left total adrenal gland. The cut-off value of cFAGV was set as >12.6 mm(3)/kg and AUC value of 0.952 (95%CI, 0.905-0.999) for right FZV(p < 0.001). The cut-off value of cFAGV was set as >7.8 mm(3)/kg and AUC value of 0.884 (95%CI, 0.752-1.000) for left FZV (p < 0.001). Conclusions Two-dimension ultrasonographic measurement is an easy-to-access and noninvasive method that can be integrated into the algorithms to predict the success of induction based on FAGV measurement.

Automated summary

This study aimed to investigate the predictive value of fetal adrenal gland volume (FAGV) measurement in the success of labor induction with oxytocin. The results showed that higher total volumes of fetal adrenal glands and fetal zone volumes were associated with successful labor induction. By setting specific cut-off values, the probability of induction success could be predicted.