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Effects of antenatal betamethasone on fetal doppler indices and short term fetal heart rate variation in early growth restricted fetuses

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Title: Effects of antenatal betamethasone on fetal doppler indices and short term fetal heart rate variation in early growth restricted fetuses
Authors: Fratelli, N
Prefumo, F
Wolf, H
Hecher, K
Visser, GHA
Giussani, D
Derks, JB
Shaw, CJ
Frusca, T
Ghi, T
Ferrazzi, E
Lees, CC
TRUFFLE Group
TRUFFLE Group authors
TRUFFLE Group collaborating authors
Item Type: Journal Article
Abstract: PURPOSE:  To investigate the effects of the antenatal administration of betamethasone on fetal Doppler and short term fetal heart rate variation (CTG-STV) in early growth restricted (FGR) fetuses. MATERIALS AND METHODS:  Post hoc analysis of data derived from the TRUFFLE study, a prospective, multicenter, randomized management trial of severe early onset FGR. Repeat Doppler and CTG-STV measurements between the last recording within 48 hours before the first dose of betamethasone (baseline value) and for 10 days after were evaluated. Multilevel analysis was performed to analyze the longitudinal course of the umbilico-cerebral ratio (UC ratio), the ductus venosus pulsatility index (DVPIV) and CTG-STV. RESULTS:  We included 115 fetuses. A significant increase from baseline in CTG-STV was found on day + 1 (p = 0.019) but no difference thereafter. The DVPIV was not significantly different from baseline in any of the 10 days following the first dose of betamethasone (p = 0.167). Multilevel analysis revealed that, over 10 days, the time elapsed from antenatal administration of betamethasone was significantly associated with a decrease in CTG-STV (p = 0.045) and an increase in the DVPIV (p = 0.001) and UC ratio (p < 0.001). CONCLUSION:  Although steroid administration in early FGR has a minimal effect on increasing CTG-STV one day afterwards, the effects on Doppler parameters were extremely slight with regression coefficients of small magnitude suggesting no clinical significance, and were most likely related to the deterioration with time in FGR. Hence, arterial and venous Doppler assessment of fetal health remains informative following antenatal steroid administration to accelerate fetal lung maturation.
Issue Date: 1-Feb-2021
Date of Acceptance: 1-Sep-2019
URI: http://hdl.handle.net/10044/1/78512
DOI: 10.1055/a-0972-1098
ISSN: 0172-4614
Publisher: Thieme Publishing
Start Page: 56
End Page: 64
Journal / Book Title: European Journal of Ultrasound / Ultraschall in der Medizin
Volume: 42
Issue: 01
Copyright Statement: © Georg Thieme Verlag KG Stuttgart · New York.
Keywords: TRUFFLE Group
TRUFFLE Group authors
TRUFFLE Group collaborating authors
Nuclear Medicine & Medical Imaging
Publication Status: Published
Conference Place: Germany
Online Publication Date: 2019-09-02
Appears in Collections:Department of Metabolism, Digestion and Reproduction
Faculty of Medicine