Güngör Emre Sinan, İlhan Gülşah, Gültekin Hüseyin, Zebitay Ali Galip, Cömert Serdar, Verit Fatma Ferda
Gynecology and Obstetrics Clinic, Süleymaniye Maternity Research and Education Hospital, Istanbul, Turkey.
Department of Pediatrics, Division of Neonatology, Süleymaniye Maternity Research and Education Hospital, Istanbul, Turkey.
J Ultrasound Med. 2017 Dec;36(12):2441-2445. doi: 10.1002/jum.14280. Epub 2017 Jun 19.
Respiratory distress syndrome (RDS) is a major cause of neonatal morbidity and mortality. It is primarily a disease of premature neonates. The aim of this study was to evaluate the impact of maternal betamethasone administration on the fetal pulmonary arteries (PAs) and umbilical arteries (UAs) and the correlation between RDS development and PA Doppler results.
Forty singleton pregnancies between 24 and 34 gestational weeks with a diagnosis of preterm birth were included prospectively. They received corticosteroids to enhance fetal lung maturity. Fetal PA and UA Doppler parameters were evaluated before and 48 to 72 hours after steroid administration. Maternal records were matched to neonatal charts, and demographic and outcome data were abstracted.
There were no differences between groups for maternal age, body mass index, mode of delivery, and mean GA at steroid administration. Apgar scores at 1 and 5 minutes were significantly lower for neonates who developed RDS (P < .05). There were no statistically significant differences in PA Doppler results between fetuses who developed RDS and those who did not, and there were no significant differences in PA Doppler results before and after steroid administration for both groups. The UA pulsatility and resistive indices were significantly lower after steroid administration for the neonates who developed RDS (P < .05).
There were no significant differences in PA Doppler indices for fetuses with or without RDS after steroid administration.
呼吸窘迫综合征（RDS）是新生儿发病和死亡的主要原因。它主要是一种早产儿疾病。本研究的目的是评估母体使用倍他米松对胎儿肺动脉（PAs）和脐动脉（UAs）的影响，以及RDS发生与肺动脉多普勒结果之间的相关性。
前瞻性纳入40例孕24至34周、诊断为早产的单胎妊娠。她们接受皮质类固醇以促进胎儿肺成熟。在给予类固醇前及给药后48至72小时评估胎儿肺动脉和脐动脉多普勒参数。将母体记录与新生儿病历匹配，并提取人口统计学和结局数据。
在母体年龄、体重指数、分娩方式以及给予类固醇时的平均孕周方面，各组之间无差异。发生RDS的新生儿1分钟和5分钟时的阿氏评分显著较低（P < 0.05）。发生RDS的胎儿与未发生RDS的胎儿之间，肺动脉多普勒结果无统计学显著差异，且两组在给予类固醇前后的肺动脉多普勒结果也无显著差异。对于发生RDS的新生儿，给予类固醇后脐动脉搏动指数和阻力指数显著降低（P < 0.05）。
给予类固醇后，发生RDS和未发生RDS的胎儿的肺动脉多普勒指数无显著差异。
