Abstract
Introduction: Spontaneous preterm birth complicates ~7% of pregnancies and causes morbidity and mortality. Although infection is a common etiology, our understanding of the fetal immune system in vivo is limited. This study aimed to utilize T2-weighted imaging and T2∗ relaxometry (which is a proxy of tissue oxygenation) of the fetal spleen in uncomplicated pregnancies and in fetuses that were subsequently delivered spontaneously prior to 32 weeks. Methods: Women underwent imaging including T2-weighted fetal body images and multi-eco gradient echo single-shot echo planar sequences on a Phillips Achieva 3T system. Previously described postprocessing techniques were applied to obtain T2-and T2∗-weighted imaging of the fetal spleen and T2-weighted fetal body volumes. Results: Among 55 women with uncomplicated pregnancies, an increase in fetal splenic volume, splenic:body volume, and a decrease in splenic T2∗ signal intensity was demonstrated across gestation. Compared to controls, fetuses who were subsequently delivered prior to 32 weeks' gestation (n = 19) had a larger spleen when controlled for the overall size of the fetus (p = 0.027), but T2∗ was consistent (p = 0.76). Conclusion: These findings provide evidence of a replicable method of studying the fetal immune system and give novel results on the impact of impending preterm birth on the spleen. While T2∗ decreases prior to preterm birth in other organs, preservation demonstrated here suggests preferential sparing of the spleen.
| Original language | English |
|---|---|
| Pages (from-to) | 419-431 |
| Number of pages | 13 |
| Journal | Fetal Diagnosis and Therapy |
| Volume | 51 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 1 Oct 2024 |
Keywords
- Chorioamnionitis
- Fetal immunity
- Infection
- Magnetic resonance imaging
- Preterm delivery
- Preterm rupture of membranes