Ultrasonographic approach to diagnosis of fetal inflammatory response syndrome: a tool for at-risk fetuses?

• Published in: American journal of obstetrics and gynecology Vol. 215; no. 1; pp. 9 - 20
• Main Authors: Mastrolia, Salvatore Andrea, MD, Erez, Offer, MD, Loverro, Giuseppe, MD, Di Naro, Edoardo, MD, Weintraub, Adi Yehuda, MD, Tirosh, Dan, MD, Baron, Joel, MD, Hershkovitz, Reli, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2016
• Subjects: Chorioamnionitis - diagnosis; Chorioamnionitis - diagnostic imaging; Chorioamnionitis - immunology; Female; fetal adrenal gland; Fetal Diseases - diagnosis; Fetal Diseases - diagnostic imaging; fetal thymus; Humans; Obstetric Labor, Premature - etiology; Obstetric Labor, Premature - immunology; Obstetrics and Gynecology; Pregnancy; Premature Birth - etiology; Premature Birth - immunology; Prenatal Diagnosis; preterm labor; splenic vein flow; Systemic Inflammatory Response Syndrome - complications; Systemic Inflammatory Response Syndrome - diagnosis; Systemic Inflammatory Response Syndrome - diagnostic imaging; Tei index; Ultrasonography, Prenatal - methods; preterm labor; fetal adrenal gland; fetal thymus; Tei index; splenic vein flow
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2016.01.164

Preterm parturition is a syndrome that may result from many underlying mechanisms. Infection and inflammation are the prominent ones. Intrauterine infection and inflammation have an effect akin to sepsis, and that is similar to systemic inflammatory response in adults. Indeed, there is evidence to support the association of a fetal inflammatory response syndrome (FIRS) to systemic infection and inflammation. The utilization of invasive procedures for the prenatal diagnosis of FIRS is associated with a risk for complications resulting from the invasive method. The progress in the imaging quality of obstetrical ultrasound and the development of novel methods for functional anatomical assessment of the fetal organs may help to identify, noninvasively, fetuses at risk for FIRS in patients presenting with preterm labor. We review the studies describing advanced sonographic modalities and the imaging findings in the heart, thymus, kidney, adrenal glands, and spleen of these fetuses.