Comparing the Effects of Antenatal Betamethasone on Doppler Velocimetry Between Intrauterine Growth Restriction With and Without Preeclampsia

摘要

Evaluation of the effects of betamethasone on patients with intrauterine growth restriction in couple with preeclampsia is not well studied. This study was designed to assess and compare the changes of Doppler flow in maternal, fetal and placental arteries in singleton pregnancies complicated by IUGR and preeclampsia which are at 24-34 weeks of gestation after betamethasone therapy. This prospective, longitudinal and multicenter study was conducted in 2013 on the 40 singleton pregnant women with IUGR fetuses and concerned over maternal or fetal well-being. Three Doppler measurements including absolutely before betamethasone, one day after betamethasone and 5 days after betamethasone administration were performed. Flow velocity waveforms were obtained from uterine arteries (UA), Umbilical (UM), and middle cerebral artery (MCA). The Systolic/Diastolic ratio (S/D), Resistance Index (RI), and Pulsatility Index (PI) were determined for waveforms. Comparison of baseline mean scores between IUGR with and without preeclampsia showed no statistically significant differences. The mean scores of UA, MCA-UM-RI, UM-S/D, UM-PI, and UM-RI did not differ statistically significant between three time points when compared trend between negative and positive preeclampsia subjects. However, UM-RI had close P value to the margin of statistical significance (P value = 0.055). In other words, in our study, UM-RI had a clear tendency to be significance. We can conclude that preeclampsia alone could not be major prognostic factor in pregnancies with IUGR. While, other prognostic factors such as gestational age, fetal weight, and fetal vascular Doppler flow may are more important for decision making about termination of preeclampsia.