Document Detail


The fetal cardiovascular response to antenatal steroids in severe early-onset intrauterine growth restriction.
MedLine Citation:
PMID:  14981365     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our aim was to study the hemodynamic effects of betamethasone on fetuses with intrauterine growth restriction (IUGR) with absent or reversed end-diastolic (ARED) umbilical artery flow. STUDY DESIGN: Color/pulsed Doppler waveforms were obtained before and after intramuscular injections of betamethasone in 19 consecutive fetuses with IUGR/ARED and 6 control fetuses. Peak velocities and pulsatility index (PI) values were obtained from the umbilical (UA) and middle cerebral (MCA) arteries and intrahepatic umbilical vein (UV). RESULTS: Ten ARED fetuses developed transient positive umbilical end-diastolic flow after steroids, whereas nine fetuses showed persistent ARED. The persistent ARED subgroup demonstrated increased UA and UV peak velocities after steroids, which may indicate fetal hypertension. Fetal death (n=2) and severe acidosis (n=2) were confined to the subgroup with persistent ARED. CONCLUSION: Preterm IUGR/ARED fetuses exhibit divergent cardiovascular responses to prenatal steroids. Intensive Doppler-based fetal monitoring may identify a subset of fetuses prone to decompensation after maternal steroid administration.
Authors:
Michal J Simchen; Fawaz Alkazaleh; S Lee Adamson; Rory Windrim; Joyce Telford; Joseph Beyene; John Kingdom
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  190     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-24     Completed Date:  2004-03-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  296-304     Citation Subset:  AIM; IM    
Affiliation:
Division of Maternal-Fetal Medicine, University of Toronto, Toronto, Ontario, Canada. michal_simchen@sheba.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Acidosis / etiology
Adult
Betamethasone / pharmacology*
Blood Flow Velocity
Female
Fetal Growth Retardation / drug therapy*,  physiopathology,  ultrasonography
Fetus / drug effects,  physiology*
Glucocorticoids / pharmacology*
Hemodynamics / drug effects
Humans
Longitudinal Studies
Pregnancy
Pregnancy Outcome
Prospective Studies
Ultrasonography, Doppler, Color
Ultrasonography, Doppler, Pulsed
Ultrasonography, Prenatal
Umbilical Arteries / physiopathology,  ultrasonography
Vascular Resistance / drug effects,  physiology
Chemical
Reg. No./Substance:
0/Glucocorticoids; 378-44-9/Betamethasone
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2004 Feb;190(2):295   [PMID:  14981364 ]
Am J Obstet Gynecol. 2004 Nov;191(5):1839; author reply 1839-40   [PMID:  15547582 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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