Predicting perinatal outcome through changes in umbilical artery Doppler studies after antenatal corticosteroids in the growth-restricted fetus
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Date
2009Author
Yu VY,
Baker, LS
Tong, S,
Murila, F,
Robertson, MC,
Wallace EM.
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
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.
URI
http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/52189http://www.ncbi.nlm.nih.gov/pubmed/19300328
Citation
Robertson MC, Murila F, Tong S, Baker LS, Yu VY, Wallace EM. 2009. Predicting perinatal outcome through changes in umbilical artery Doppler studies after antenatal corticosteroids in the growth-restricted fetus.. Obstet Gynecol. 2009 Mar;113(3):636-40. doi: 10.1097/AOG.0b013e318197bf4d..Publisher
Department of Paediatrics & Child Health, University o0f Nairobi
Collections
- Faculty of Health Sciences (FHS) [10387]