The fetal cardiovascular response to antenatal steroids in severe early-onset intrauterine growth restriction

Michal J. Simchen, Fawaz Alkazaleh, S. Lee Adamson, Rory Windrim, Joyce Telford, Joseph Beyene, John Kingdom

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Our aim was to study the hemodynamic effects of betamethasone on fetuses with intrauterine growth restriction (IUGR) with absent or reversed end-diastolic (ARED) umbilical artery flow. Study design: Color/pulsed Doppler waveforms were obtained before and after intramuscular injections of betamethasone in 19 consecutive fetuses with IUGR/ARED and 6 control fetuses. Peak velocities and pulsatility index (PI) values were obtained from the umbilical (UA) and middle cerebral (MCA) arteries and intrahepatic umbilical vein (UV). Results: Ten ARED fetuses developed transient positive umbilical end-diastolic flow after steroids, whereas nine fetuses showed persistent ARED. The persistent ARED subgroup demonstrated increased UA and UV peak velocities after steroids, which may indicate fetal hypertension. Fetal death (n = 2) and severe acidosis (n = 2) were confined to the subgroup with persistent ARED. Conclusion: Preterm IUGR/ARED fetuses exhibit divergent cardiovascular responses to prenatal steroids. Intensive Doppler-based fetal monitoring may identify a subset of fetuses prone to decompensation after maternal steroid administration.

Original languageEnglish
Pages (from-to)296-304
Number of pages9
JournalAmerican Journal of Obstetrics and Gynecology
Volume190
Issue number2
DOIs
StatePublished - Feb 2004
Externally publishedYes

Keywords

  • Betamethasone
  • Fetal Doppler
  • Intrauterine growth restriction
  • Perinatal outcome
  • Steroids

Fingerprint

Dive into the research topics of 'The fetal cardiovascular response to antenatal steroids in severe early-onset intrauterine growth restriction'. Together they form a unique fingerprint.

Cite this