| Predicting perinatal outcome through changes in umbilical artery Doppler studies after antenatal corticosteroids in the growth-restricted fetus. | |
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MedLine Citation:
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PMID: 19300328 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate whether persistently absent umbilical artery end-diastolic flow in the intrauterine growth-restricted fetus after betamethasone administration is associated with altered perinatal outcomes. METHODS: This is a retrospective cohort study of 92 pregnancies complicated by intrauterine growth restriction (IUGR) and absent end-diastolic flow in which antenatal betamethasone was given. Predefined maternal outcomes (maternal age, gestational age at diagnosis of absent end-diastolic flow, gestational age at delivery, preexisting medical conditions) and neonatal outcomes (including birth weight; perinatal mortality; duration of neonatal intensive care unit admission; requirement for intubation, assisted ventilation, inotropic support; duration of supplemental oxygen, assisted ventilation; respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage) were analyzed. RESULTS: Betamethasone administration was associated with a transient return of end-diastolic umbilical artery flow in 58 pregnancies (63%) and persistent absent end-diastolic flow in 34 (37%). Persistent absent end-diastolic flow was seen more frequently in women with prepregnancy medical disorders (59% compared with 24%, P<.001). Neonates from the persistent absent end-diastolic flow subgroup were more likely to require assisted ventilation (93.1% compared with 73.5%, P=.03) and to have longer durations of assisted ventilation (median time 30 days compared with 4 days, P=.03) and supplemental oxygen (median time 45 days compared with 4 days, P=.04). CONCLUSION: Betamethasone administration is associated with a transient return of end-diastolic flow in two thirds of pregnancies complicated by IUGR and umbilical artery absent end-diastolic flow. Persistent absent end-diastolic flow in the umbilical artery after betamethasone administration may identify a subgroup of fetuses with IUGR at further heightened perinatal risk that, as neonates, are more likely to require assisted ventilation and a longer duration of ventilation and supplemental oxygen. |
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Authors:
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Marcus C Robertson; Florence Murila; Stephen Tong; Lesleigh S Baker; Victor Y Yu; Euan M Wallace |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 113 ISSN: 0029-7844 ISO Abbreviation: Obstet Gynecol Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-20 Completed Date: 2009-04-14 Revised Date: 2009-10-26 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 636-40 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynaecology, Monash Institute of Medical Research, Monash University, Monash Medical Centre, Southern Health, Clayton, Victoria, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Betamethasone / administration & dosage, therapeutic use* Female Fetal Growth Retardation / physiopathology*, ultrasonography Glucocorticoids / administration & dosage, therapeutic use* Humans Pregnancy Pregnancy Outcome* Regional Blood Flow Stroke Volume Ultrasonography, Doppler Ultrasonography, Prenatal Umbilical Arteries / physiopathology*, ultrasonography |
| Chemical | |
Reg. No./Substance:
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0/Glucocorticoids; 378-44-9/Betamethasone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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