Edwards Andrew, Baker Lesleigh S, Wallace Euan M
Maternal-Fetal Medicine Unit, Monash Medical Centre, Clayton, Victoria, Australia.
Placenta. 2003 Jan;24(1):12-6. doi: 10.1053/plac.2002.0874.
In a retrospective cohort study we have previously shown that administration of betamethasone to women with a pregnancy complicated by absent end-diastolic flow in the umbilical artery (UA) is associated with altered UA flow velocity waveforms. To examine this phenomenon further we undertook a prospective study of 30 similar singleton pregnancies. Umbilical artery FVWs were recorded before and after betamethasone administration using real-time pulsed wave colour flow Doppler. The results of this prospective cohort were similar to those of the retrospective study allowing pooling of the data. Of the 55 total pregnancies with umbilical artery AEDF studied betamethasone administration was associated with the return of end-diastolic flow in 39 (71 per cent; 95 per centCI: 59-83 per cent). The median (range) duration of this change was 3 (1-10) days. There is no evidence that this change has either a beneficial or detrimental effect on foetal health. Administration of betamethasone to women with a pregnancy complicated by umbilical artery AEDF is associated with the transient return of end-diastolic flow in most cases. While the mechanisms underlying this effect are yet to be fully elucidated it has implications for foetal surveillance in these high-risk pregnancies.
在一项回顾性队列研究中，我们之前已经表明，给妊娠合并脐动脉舒张末期血流缺失（UA）的女性使用倍他米松与脐动脉血流速度波形改变有关。为了进一步研究这一现象，我们对30例类似的单胎妊娠进行了一项前瞻性研究。使用实时脉冲波彩色血流多普勒在使用倍他米松前后记录脐动脉血流速度波形（FVWs）。这项前瞻性队列研究的结果与回顾性研究相似，从而可以合并数据。在总共55例研究了脐动脉舒张末期血流缺失（AEDF）的妊娠中，使用倍他米松与39例（71%；95%可信区间：59 - 83%）舒张末期血流的恢复有关。这种变化的中位（范围）持续时间为3（1 - 10）天。没有证据表明这种变化对胎儿健康有有益或有害的影响。给妊娠合并脐动脉AEDF的女性使用倍他米松在大多数情况下与舒张末期血流的短暂恢复有关。虽然这种效应的潜在机制尚未完全阐明，但它对这些高危妊娠的胎儿监测有影响。
