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Effect of maternal betamethasone on fetal and uteroplacental blood flow velocity waveforms.

Thuring, Ann LU ; Malcus, Peter LU and Marsal, Karel LU (2011) In Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology 37(6). p.668-672
Abstract
Abstract

OBJECTIVES:

To investigate the effects of antenatal betamethasone on fetal and uteroplacental hemodynamics.



METHODS:

The study comprised 33 women with singleton high-risk pregnancies (23-33 weeks; 27 pregnancies < 30 weeks) not in labor, but at risk for preterm delivery based on fetal or maternal indications. They were treated with two doses of 12 mg betamethasone intramuscularly 24 h apart to enhance fetal lung maturity. Flow velocity waveforms were recorded with Doppler ultrasound from the umbilical artery, the fetal middle cerebral artery, the ductus venosus and both maternal uterine arteries, once before and twice after betamethasone administration.



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Abstract

OBJECTIVES:

To investigate the effects of antenatal betamethasone on fetal and uteroplacental hemodynamics.



METHODS:

The study comprised 33 women with singleton high-risk pregnancies (23-33 weeks; 27 pregnancies < 30 weeks) not in labor, but at risk for preterm delivery based on fetal or maternal indications. They were treated with two doses of 12 mg betamethasone intramuscularly 24 h apart to enhance fetal lung maturity. Flow velocity waveforms were recorded with Doppler ultrasound from the umbilical artery, the fetal middle cerebral artery, the ductus venosus and both maternal uterine arteries, once before and twice after betamethasone administration.



RESULTS:

Twenty-one (64%) women delivered within 4 days, nine (27%) women within 5-7 days and three (9%) within 8-15 days after the first dose of betamethasone. Two days after betamethasone, a decrease in pulsatility index was found in the umbilical artery (P = 0.0002) and ductus venosus (P = 0.003). Changes in the umbilical artery waveform from reversed to absent, and from absent to positive diastolic flow, were noted in 12 of 15 cases (P < 0.01). After 4 days, umbilical artery and ductus venosus velocity waveforms in the undelivered fetuses either returned to the type of waveform observed before treatment or showed further deterioration. No significant effects of betamethasone were observed in the fetal middle cerebral artery and uteroplacental circulation.



CONCLUSIONS:

Maternal antenatal betamethasone resulted in a significant transient change in the velocity waveform and a decrease in the pulsatility index in the umbilical artery and ductus venosus, but did not influence uteroplacental circulation. These findings indicate a direct effect of betamethasone on fetal circulation (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
volume
37
issue
6
pages
668 - 672
publisher
John Wiley & Sons
external identifiers
  • WOS:000291092100008
  • PMID:21618314
  • Scopus:79957589343
ISSN
1469-0705
DOI
10.1002/uog.8879
language
English
LU publication?
yes
id
dbf45811-164e-4a9b-8669-18fbaa60e4f8 (old id 1972039)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21618314?dopt=Abstract
date added to LUP
2011-06-07 22:57:38
date last changed
2017-01-01 07:54:09
@article{dbf45811-164e-4a9b-8669-18fbaa60e4f8,
  abstract     = {Abstract<br/><br>
OBJECTIVES:<br/><br>
To investigate the effects of antenatal betamethasone on fetal and uteroplacental hemodynamics.<br/><br>
<br/><br>
METHODS:<br/><br>
The study comprised 33 women with singleton high-risk pregnancies (23-33 weeks; 27 pregnancies &lt; 30 weeks) not in labor, but at risk for preterm delivery based on fetal or maternal indications. They were treated with two doses of 12 mg betamethasone intramuscularly 24 h apart to enhance fetal lung maturity. Flow velocity waveforms were recorded with Doppler ultrasound from the umbilical artery, the fetal middle cerebral artery, the ductus venosus and both maternal uterine arteries, once before and twice after betamethasone administration.<br/><br>
<br/><br>
RESULTS:<br/><br>
Twenty-one (64%) women delivered within 4 days, nine (27%) women within 5-7 days and three (9%) within 8-15 days after the first dose of betamethasone. Two days after betamethasone, a decrease in pulsatility index was found in the umbilical artery (P = 0.0002) and ductus venosus (P = 0.003). Changes in the umbilical artery waveform from reversed to absent, and from absent to positive diastolic flow, were noted in 12 of 15 cases (P &lt; 0.01). After 4 days, umbilical artery and ductus venosus velocity waveforms in the undelivered fetuses either returned to the type of waveform observed before treatment or showed further deterioration. No significant effects of betamethasone were observed in the fetal middle cerebral artery and uteroplacental circulation.<br/><br>
<br/><br>
CONCLUSIONS:<br/><br>
Maternal antenatal betamethasone resulted in a significant transient change in the velocity waveform and a decrease in the pulsatility index in the umbilical artery and ductus venosus, but did not influence uteroplacental circulation. These findings indicate a direct effect of betamethasone on fetal circulation},
  author       = {Thuring, Ann and Malcus, Peter and Marsal, Karel},
  issn         = {1469-0705},
  language     = {eng},
  number       = {6},
  pages        = {668--672},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology},
  title        = {Effect of maternal betamethasone on fetal and uteroplacental blood flow velocity waveforms.},
  url          = {http://dx.doi.org/10.1002/uog.8879},
  volume       = {37},
  year         = {2011},
}