Effect of Antenatal Corticosteroid on Cardiotocographic Parameters in Pregnant Women
DOI:
https://doi.org/10.37506/4zyt3y86Keywords:
Cardiotocography (CTG), Antenatal corticosteroidsAbstract
Objective: To evaluate the effect of dexamethasone administration on cardiotocographic parameters.
Material & Methods: A prospective cohort study was carried out in the department of Obstetrics and Gynaecology in collaboration with Department of physiology, Jawaharlal Nehru Medical College & Hospital. Total 100 pregnant women between gestational age of 28 weeks to 38 weeks were enrolled in the study. They underwent cardiotocography on day 0 i.e. before administration of injection dexamethasone, on day 2 (after 48 hours of first dose) and on day 4-7. Patients received injection dexamethasone 6 mg i.m. 4 doses at an interval of 12 hours for various indications like preterm labor (PTL), preterm prelabor rupture of membrane (PPROM), placenta previa and previous CS. Outcome measures were changes in Baseline FHR(Fetal Heart Rate), Baseline variability, Acceleration and DFMC before and after dexamethasone administration.
Results: All parameters including Baseline FHR, Accelerations, baseline variability and daily fetal movement counts were significantly reduced on day 2 of injection dexamethasone administration and returned to baseline values after 4 to 7 days of receiving dexamethasone.
Conclusions: Dexamethasone administration resulted in transient reduction in baseline FHR, acceleration, variability and DFMC that mimic fetal compromise, hence clinicians should be aware of this phenomena to avoid iatrogenic preterm delivery of the fetus.
References
Wimmer JE. Levels of care for perinatal health. North Carolina medical journal. 2020 Jan 1; 81(1):32-5.
RCOG Green Top guidelines No. 7: Antenatal corticosteroids to reduce neonatal morbidity and mortality. London: RCOG. 2010 Oct.
Antinatal corticosteroid therapy for fetal maturation. Committee opinion no 713. American College of Obstetricians and Gynecologists. Obstet Gynecol Aug 2017; Vol130, No2: e102-109.
Rotmensch S, Celentano C, Liberati M, Sadan O, Glezerman M: The effect of antenatal steroid administration on the fetal response to vibroacustic stimulation. Acta Obstet Gynecol Scand. 1999; 78: 847–851.
Mulder EJ, Koenen SV, Blom I, Visser GH. The effects of antenatal betamethasone administration on fetal heart rate and behavior depend on gestational age. Early human development. 2004 Jan 1; 76 (1):65-77.
Elimian A, Garry D, Figueroa R, Spitzer A, Wiencek V, Quirk JG. Antenatal betamethasone compared with dexamethasone (betacode trial): a randomized controlled trial. Obstet Gynecol. 2007 Jul 1; 110(1):26-30.
Noben L, Verdurmen KM, Warmerdam GJ, Vullings R, Oei SG, van Laar JO. The fetal electrocardiogram to detect the effects of betamethasone on fetal heart rate variability. Early human development. 2019 Mar 1; 130:57-64.
Graatsma EM, Mulder EJ, Vasak B, Lobmaier SM, Pildner von Steinburg S, Schneider KT, Schmidt G, Visser GH. Average acceleration and deceleration capacity of fetal heart rate in normal pregnancy and in pregnancies complicated by fetal growth restriction. The Journal of Maternal-Fetal & Neonatal Medicine. 2012 Dec 1; 25(12):2517-22.
Frusca T, Soregaroli M, Valcamonico A, Scalvi L, Bonera R, Bianchi U. Effect of betamethasone on computerized cardiotocographic parameters in preterm growthrestricted fetuses with and without cerebral vasodilation. Gynecologic and obstetric investigation. 2001; 52(3):194-7.
Rotmensch S, Lev S, Kovo M, Efrat Z, Zahavi Z, Lev N, Celentano C, Ben-Rafael Z. Effect of betamethasone administration on fetal heart rate tracing: a blinded longitudinal study. Fetal diagnosis and therapy. 2005; 20(5):371-6.
Derks JB, Mulder EJ, Visser GH. The effects of maternal betamethasone administration on the fetus. BJOG: An International Journal of Obstetrics & Gynaecology. 1995 Jan;102(1):40-6.
Ahmed AA, Sayed Ahmed WA, Taha OT. Effect of Dexamethasone on Antepartum Cardiotocography. Austin J Obstet Gynecol. 2021; 8(1):11.
Magee LA, Dawes GS, Moulden M, Redman CW. A randomized controlled comparison of betamethasone with dexamethasone: effects on the antenatal fetal heart rate. BJOG: An International Journal of Obstetrics & Gynaecology. 1997 Nov; 104(11):1233-8.
Subtil D, Tiberghien P, Devos P, Therby D, Leclerc G, Vaast P, Puech F. Immediate and delayed effects of antenatal corticosteroids on fetal heart rate: a randomized trial that compares betamethasone acetate and phosphate, betamethasone phosphate, and dexamethasone. American journal of obstetrics and gynecology. 2003 Feb 1; 188(2):524-31.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
https://creativecommons.org/licenses/by-nc/2.0/deed.en