Effects of betamethasone on fetoplacental and maternal hemodynamics in preterm pregnancies

• Published in: International journal of gynecology and obstetrics Vol. 141; no. 3; pp. 354 - 359
• Main Authors: Inan, Cihan, Sayin, N. Cenk, Dolgun, Zehra N., Erzincan, Selen G., Uzun, Isil, Sutcu, Havva, Sut, Necdet, Varol, Fusun G.
• Format: Journal Article
• Language: English
• Published: United States 01.06.2018
• Subjects: Betamethasone; Cerebroplacental ratio; Doppler ultrasonography; Middle cerebral artery; Preterm birth; Umbilical artery; Doppler ultrasonography; Preterm birth; Umbilical artery; Betamethasone; Cerebroplacental ratio; Middle cerebral artery
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1002/ijgo.12478

Objective To evaluate the possible effects of prenatal steroid administration on Doppler parameters of the umbilical artery, uterine artery, middle cerebral artery, and ductus venosus, the cerebroplacental ratio, and the amniotic fluid index in preterm fetuses. Methods The present prospective observational study was performed at the Perinatology Department of Trakya University, Edirne, Turkey, between June 1, 2015, and September 1, 2016. It included patients with healthy singleton pregnancies who had received betamethasone at 24–34 weeks of pregnancy. Doppler parameters were measured before (0 hours) and 24, 48, and 72 hours after the administration of betamethasone (two intramuscular doses of 12 mg each, administered 24 hours apart). Results There were 68 patients included. Pairwise comparisons demonstrated that, at 72 hours after betamethasone administration, the umbilical artery resistance index (P=0.038), the middle cerebral artery systolic/diastolic velocity ratio (P=0.007), and the amniotic fluid index (P=0.017) were reduced, whereas the end‐diastolic velocity of the middle cerebral artery was increased (P=0.012), compared with baseline values. Conclusion Betamethasone had favorable effects on fetal cerebral circulation, with increased end‐diastolic velocity in the middle cerebral artery; this could represent a positive effect on cerebral blood circulation and decreased flow resistance in the umbilical artery. Betamethasone administration in preterm pregnancies resulted in improvements in the fetal cerebral circulation (reduced umbilical artery resistance index; increased middle cerebral artery end‐diastolic velocity).