Aim of the Work
The aim of this study is to compare the effects of antenatal maternal dexamethasone versus betamethasone administration on maternal hematologic parameters, fetal Doppler Indices and fetal heart rate patterns.
Material and methods:
The study included 100 cases of high risk pregnant women admitted to the department and candidates for corticosteroids therapy for possible preterm birth, in a prospective cohort study at Benha university Hospitals. All patients were subjected to US examination, powered doppler ultrasonographic evaluation of the Umbilical and middle cerebral arteries, CTG recording and maternal blood sample before and after corticosteroids administration.
Results:
• In the present study, as regard Doppler velocimetry:
The effects of dexamethasone versus betamethasone on fetal Doppler were compared, it was found that betamethasone had statistically significant decrease in UAPI and MCAPI on day 2 after administration as compared to dexamethasone.
• As regard CTG parameters:
When the effects of dexamethasone versus betamethasone on CTG parameters were compared, it was found that betamethasone had statistically significant decrease on FHRV on day 2 after administration as compared to dexamethasone (P < 0.018).
No statistically significant differences between the two drugs regarding the effect on the number of accelerations and FMs on day 1, 2 and 3 after administration.
In addition, dexamethasone showed statistically significant decrease in the baseline FHR on day 2 and 3 after administration as compared to betamethasone. The explanation of this finding is not clear.
• As regard maternal hematological parameters:
When the effects of dexamethasone versus betamethasone on maternal hematological parameters were compared, there was no statistically significant difference between the two drugs regarding the effect on hemoglobin, hematocrit, WBCs, neutrophil, FBS and platelets count on day 1 and 2 after administration
Corticosteroid-induced leukocytosis may complicate the management of women with PPROM as it may be interpreted as being secondary to infection leading to inappropriate intervention. On the other hand, if an infection-related leukocytosis is wrongly attributed to corticosteroid administration then a necessary delivery may be delayed
Awareness of the pharmacologic effect of corticosteroids on parameters for the assessment of fetal well-being might prevent unnecessary iatrogenic delivery of preterm fetuses. However, the differential diagnosis between pathophysiologic and pharmacologic effect can be extremely difficult.
|
