The effect of betamethasone on fetal biophysical activities and Doppler velocimetry of umbilical and middle cerebral arteries

Abstract

Betamethasone induces a profound, albeit transient, suppression of fetal breathing, limb and trunk movements, resulting in decreased biophysical profile scores. Awareness of this drug-induced effect might prevent unnecessary iatrogenic delivery of preterm fetuses.

Effects of betamethasone on fetoplacental and maternal hemodynamics in preterm pregnancies

“…Several studies 5,6,8,13,16 have investigated the effect of betamethasone on Doppler parameters of the MCA and found decreased or unchanged MCA PI levels in different patient groups. In some of these studies, 5,13,16 a PI decrease was observed in both complicated pregnancies and those pregnancies that already had a high MCA PI before betamethasone administration.…”

“…[5][6][7] Other studies have evaluated the effects of steroids on the biophysical profile; these studies have revealed reductions in fetal movement, breathing, or amniotic fluid index (AFI), resulting in decreased biophysical profile scores. 8,9 The present study investigated the unanticipated effects of betamethasone on fetomaternal blood flow and AFI.…”

Effect of Betamethasone Administration on Fetal Heart Rate Tracing: A Blinded Longitudinal Study

“…It is now well documented that fetal breathing movements are reduced by more than 85% [5,10,20] following steroid administration, and fetal body and limb movements by more than 50% [5,10] . Consequently, 45 and 13% of normal fetuses had a biophysical profi le score of 6/8 and 4/8, respectively, 48 h after steroid exposure [11] . Furthermore, the response to vibroacoustic stimulation is similarly suppressed, with 73% of fetuses showing no response or sluggish response 48 h after steroid exposure [12] .…”

“…Multiple studies have shown that antenatal corticosteroids suppress central nervous system responses of the fetus, which could lead to the erroneous diagnosis of fetal distress and result in unnecessary iatrogenic delivery of premature infants. Most indicators of fetal well-being, including fetal heart rate (FHR) accelerations and FHR variability [4][5][6][7][8][9] , fetal trunk and breathing movements [4,5,7,10,11] , and response to vibroacoustic stimulation [12] are pharmacologically suppressed by corticosteroids.…”

Einfluss von zirkadianer Rhythmik auf fetale und maternale Dopplerparameter - Ist eine tageszeitliche Veränderung nachweisbar?

“…Uterinae nachgewiesen werden. Im Gegensatz dazu konnte [9] beim menschlichen Feten keine zirkadiane Rhythmik in Dopplerparametern der A. umbilicalis und A. cerebri media dargestellt werden. In einigen Studien [10,11] zu dieser Thematik bei Neugeborenen wurde eine zirkadiane Rhythmik in der Aorta nachgewiesen [10], nicht jedoch [11] in der A. cerebri media.…”