Hantoushzadeh Sedigheh, Amiri Amir, Shabani Azadeh, Soufi Enayati Yasamin, Mostafaeipour Neda, Houra Mousavi Vahed Seyede, Nezamnia Maria, Sheykhian Toktam
Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Maternal, Fetal, and Neonatal Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Int J Reprod Biomed. 2024 Jul 8;22(5):375-382. doi: 10.18502/ijrm.v22i5.16436. eCollection 2024 May.
The administration of antenatal corticosteroid is a standard treatment to reduce the rate of perinatal mortality and morbidity; however, there is limited evidence regarding the potential effects of betamethasone on the constriction of the ductus arteriosus (DA).
This study aimed to investigate the short-term effects of antenatal betamethasone on fetal cardiovascular and circulation status.
This quasi-experimental observational (before-after) study was conducted on 32 singleton fetuses. The participants were healthy pregnant women with a diagnosis of placenta accreta spectrum who were eligible for 2 doses of betamethasone and referred to prenatal care clinic, Vali-E-Asr hospital, Tehran, Iran from January 2021-May 2022. The results of fetal echocardiography and Doppler sonography were compared before and after the administration of antenatal corticosteroid therapy.
Following betamethasone injection, significant increases were observed in peak systolic and diastolic velocity of the DA without constriction of the DA (p 0.001, p = 0.002 respectively). However, no significant changes were observed in right ventricular function, tricuspid valve function, Doppler of ductus venous, and peak systolic velocity of the aortic isthmus (p 0.05). Doppler examination of the uterine, umbilical, and middle cerebral arteries also showed no significant changes (p 0.05).
Considering the benefits of antenatal corticosteroid therapy, its administration seems reasonable in preterm births. The transient changes in ductal blood flow are not prohibitive.
产前使用糖皮质激素是降低围产期死亡率和发病率的标准治疗方法；然而，关于倍他米松对动脉导管（DA）收缩的潜在影响的证据有限。
本研究旨在探讨产前倍他米松对胎儿心血管和循环状态的短期影响。
本准实验性观察性（前后对照）研究对32例单胎胎儿进行。参与者为诊断为胎盘植入谱系的健康孕妇，符合接受2剂倍他米松治疗的条件，并于2021年1月至2022年5月转诊至伊朗德黑兰瓦利 - 阿斯尔医院的产前保健诊所。比较产前糖皮质激素治疗前后胎儿超声心动图和多普勒超声检查的结果。
注射倍他米松后，观察到DA的收缩期峰值和舒张期速度显著增加，且DA未发生收缩（分别为p < 0.001，p = 0.002）。然而，右心室功能、三尖瓣功能、静脉导管多普勒以及主动脉峡部的收缩期峰值速度均未观察到显著变化（p > 0.05）。子宫、脐动脉和大脑中动脉的多普勒检查也未显示出显著变化（p > 0.05）。
考虑到产前糖皮质激素治疗的益处，在早产中使用似乎是合理的。导管血流的短暂变化并不构成禁忌。
