Abstract
BackgroundPrenatal corticosteroid administration is known to be an effective strategy in improving fetal pulmonary maturity. This study aimed to evaluate the impact of maternal betamethasone administration on fetal pulmonary and other arteries Doppler velocity and the correlation between RDS development and Doppler indices results.MethodsFifty one singleton pregnancies between 26 and 34 gestational weeks with a diagnosis of preterm labor were included in the exposed group and received betamethasone. Fifty one uncomplicated pregnancies were included in the non-exposed group. Fetal pulmonary, umbilical and middle cerebral arteries Doppler parameters were evaluated before and 24 to 48 h after steroid administration in the exposed group and two times at same intervals in the non-exposed group. Maternal records were matched to neonatal charts if delivery happened, and demographic and outcome data were abstracted.ResultsWhen compared with the nonexposed group, fetuses treated with corticosteroids demonstrated significantly decreased umbilical artery Pulsatility index (PI) and significantly increased the middle cerebral artery PI, pulmonary artery Acceleration time (AT) and pulmonary artery AT/ET (Ejection time), while all other indices remained similar. We found significantly decreased pulmonary artery AT in the fetuses with respiratory distress syndrome (RDS) compared to those that did not.ConclusionsThe results of our study showed that maternal antenatal betamethasone administration caused significant changes in the fetus blood velocity waveforms and also affected the blood flow in the pulmonary artery which led to an increase in the pulmonary artery AT and AT/ET. Among those fetuses with RDS, we found a significant decrease in the pulmonary artery AT, but we did not observe any pulmonary artery AT/ET differences.
Highlights
Preterm birth, described by the world health organization (WHO) as delivery before 37 weeks of gestation, is a leading cause of neonatal morbidity and mortality [1].Preterm birth is a risk factor in over 50 % of all neonatal deaths
This study aimed to evaluate the effect of maternal betamethasone administration on fetal pulmonary, umbilical and middle cerebral arteries Doppler indices and to investigate their relationship with the incidence of neonatal respiratory distress syndrome
Later, 12 patients in the exposure group were excluded from the study, 4 cases due to delivery before completing the corticosteroid course, 6 cases due to delivery after receiving a corticosteroid course but before the second Doppler examination, and 2 cases due to inability to examine the pulmonary artery Doppler
Summary
Preterm birth is a risk factor in over 50 % of all neonatal deaths. The past few decades have seen significant development in outcomes for preterm infants due to the introduction of sophisticated neonatal ventilation, the use of exogenous surfactant, and the administration of antenatal steroid. There are two different courses of standard corticosteroid therapy to accelerate fetal lung maturation: 1. Administration of betamethasone 12 mg intramuscularly and repetition of the same dose 24 h later 2. Prenatal corticosteroid administration is known to be an effective strategy in improving fetal pulmonary maturity. This study aimed to evaluate the impact of maternal betamethasone administration on fetal pulmonary and other arteries Doppler velocity and the correlation between RDS development and Doppler indices results
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