The impact of betamethasone on fetal pulmonary, umbilical and middle cerebral artery Doppler velocimetry and its relationship with neonatal respiratory distress syndrome

• Published in: BMC pregnancy and childbirth Vol. 21; no. 1; p. 188
• Main Authors: Vafaei, Homeira, Kaveh Baghbahadorani, Fahimeh, Asadi, Nasrin, Kasraeian, Maryam, Faraji, Azam, Roozmeh, Shohreh, Zare, Marjan, Bazrafshan, Khadije
• Format: Journal Article
• Language: English
• Published: England BioMed Central 06-03-2021; BMC
• Subjects: Adult; Amniocentesis; Amniotic fluid; Betamethasone; Betamethasone - administration & dosage; Blood Flow Velocity - drug effects; Blood pressure; Drug dosages; Female; Fetal lung maturity; Fetal Organ Maturity - drug effects; Fetal pulmonary artery; Fetus - blood supply; Fetus - diagnostic imaging; Fetuses; Gestational age; Glucocorticoids - administration & dosage; Humans; Infant, Newborn; Lungs; Middle Cerebral Artery - diagnostic imaging; Newborn babies; Obstetric Labor, Premature - diagnosis; Obstetric Labor, Premature - drug therapy; Outcome Assessment, Health Care; Pregnancy; Premature birth; Prenatal Care - methods; Pulmonary arteries; Pulmonary Artery - diagnostic imaging; Respiratory distress syndrome; Respiratory Distress Syndrome, Newborn - diagnosis; Respiratory Distress Syndrome, Newborn - epidemiology; Respiratory Distress Syndrome, Newborn - prevention & control; Surfactants; Ultrasonic imaging; Ultrasonography, Doppler - methods; Ultrasonography, Prenatal - methods; Umbilical Arteries - diagnostic imaging; Veins & arteries; Respiratory distress syndrome; Betamethasone; Fetal lung maturity; Fetal pulmonary artery
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-021-03655-2

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.
Fifty 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.
When 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.
The 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.