Comparison Between Changes In Doppler Indices In Intrauterine Growth Retardation Before And After Dexamethasone Administration

Document Type : Original Article

Authors

Obstetrics and Gynecology department, Faculty of Medicine, Beni-Suef University, Egypt

Abstract

Background: Intrauterine growth restriction (IUGR) is associated with stillbirth, neonatal death, and perinatal morbidity. In the majority of cases, IUGR is due to placental insufficiency but may also be due to a number of other conditions for example congenital anomalies, infections, or drug and substance misuse. There is no method for precise identification of intrauterine growth restricted babies antenatally. The most critical decision is the timing of delivery of those restricted fetuses. There is no current treatment available for intrauterine growth restriction (IUGR); the only management option obstetricians can offer is early birth.  Objectives: The aim of this work is to detect any change in the cerebroplacental Doppler ratio in IUGR fetuses before and after receiving Dexamethasone.  Setting: Department of Obstetrics &Gynecology, Beni-Suef University Hospital.
Methods: The present study was designed as a Prospective Study including 100 pregnant women diagnosed as IUGR. The cases were offered Dexamethasone 8 mg / intramuscular every 12 hours for 48 hours. We excluded patients with multiple pregnancies, fetal congenital anomalies, and maternal diabetes mellitus as co-morbidity and maternal use of heparin, low dose aspirin or if there is planned termination of pregnancy. All patients underwent ultrasonography to determine gestational age and presence of IUGR and we measured the Doppler indices and biophysical profile. Then Doppler indices repeated again after 12 hours and 24 hours of receiving last dose of dexamethasone.. Results::The results show significant statistical difference in UA, MCA and also cerebroplacental ratio significantly decreased at the end of study in indices before and after dexamethasone administration. Conclusions: The current study finds in healthy fetuses a transient, significant and unexplained decrease in fetal middle cerebral artery impedance on the fourth day following maternal dexamethasone administration.

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References

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