Predicting Perinatal Outcome Through Changes in Umbilical Artery Doppler Studies After Antenatal Corticosteroids in the Growth-restricted Fetus

Robertson, Marcus; Murila, Florence; Tong, Stephen; Baker, Lesleigh S; Yu, V. Y. H.; Wallace, Euan M.

doi:10.1097/01.aoa.0000362089.18580.c9

Cited by 13 publications

(19 citation statements)

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“…On d 5 following surgery, ewes received either 11.4 mg BM intramuscular (termed BM1; Celestone Chronodose; Schering Plough, Sydney, Australia) or an equal volume of saline and then received a second dose of 11.4 mg BM or saline 24 h later on d 6 (termed BM2). This dosing regimen reflects the clinical use of BM (37,38). Thus, there were four treatment groups: control, SUAL-alone, control + BM, and SUAL + BM.…”

Section: Methodsmentioning

confidence: 99%

The effects of intrauterine growth restriction and antenatal glucocorticoids on ovine fetal lung development

et al. 2012

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IntroductIon: Intrauterine growth restriction (IUGR) is associated with high rates of neonatal morbidity. IUGR babies are often born preterm and are, therefore, exposed to antenatal glucocorticoids. antenatal glucocorticoids significantly improve overall survival rates of preterm infants, but there is a paucity of information about their effects on IUGR Infants. Methods: We induced IUGR in sheep by single umbilical artery ligation (sUaL), or sham in control fetuses. To half the ewes, we administered betamethasone (BM) on d 5 (BM1) and 6 (BM2) following surgery, and collected fetal lung tissue on d 7. results: sUaL alone was associated with higher circulating fetal cortisol levels (2.8 ± 0.4 vs. 1.0 ± 0.4, P = 0.001) as compared with controls but not with changes in lung morphology or surfactant protein (SP) gene expression. BM was associated with a significant reduction in lung tissue density (P = 0.048). There were no significant differences between groups in lung DNa concentration or septal crest density. SP-A, SP-B, and SP-C gene expressions were significantly increased in control and sUaL fetuses that were administered BM. dIscussIon: These results show that in sUaL fetuses, maternal BM is associated with acceleration of fetal lung structure, as occurs in normally grown fetuses, and that BM induces sP production, an effect not observed in sUaL-induced IUGR fetuses alone.

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Section: Methodsmentioning

confidence: 99%

The effects of intrauterine growth restriction and antenatal glucocorticoids on ovine fetal lung development

et al. 2012

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“…It has elsewhere been reported as 63% (58/92) (Robertson et al, 2009) and 81.8% (9/11) (Thuring et al, 2011) in singleton pregnancies with UA-AEDF. So the incidence of betamethasone-induced return of positive end-diastolic flow in singleton pregnancies is higher than those reported for multiple pregnancies.…”

Section: Discussionmentioning

confidence: 81%

“…In singleton pregnancies with an absence of end-diastolic flow (AEDF) in the umbilical artery (UA) Doppler, betamethasone administration had been reported as associated with a transient return of positive UA end-diastolic flow in 63% (Robertson et al, 2009) and 81.8% of cases (Thuring et al, 2011). But the etiology of betamethasoneinduced return of positive end-diastolic UA flow is unclear (Robertson et al, 2009).…”

mentioning

confidence: 99%

“…But the etiology of betamethasoneinduced return of positive end-diastolic UA flow is unclear (Robertson et al, 2009). Selective intrauterine growth restriction (sIUGR) occurs in about 12% of monochorionic twin (MC) pregnancies (Gaziano et al, 2000;Gratacos et al, 2004;Sebire et al, 1997); MC twins have a higher incidence of respiratory and neurological complications than their dichorionic counterparts (Acosta-Rojas et al, 2007;Fick et al, 2006;Gonzalez-Quintero et al, 2003).…”

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confidence: 99%

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Placenta Share Discordance and Umbilical Artery Doppler Change After Antenatal Betamethasone Administration in Monochorionic Twins With Selective Intrauterine Growth Restriction: Is There a Link?

Chang

Chao

et al. 2012

Twin Res Hum Genet

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This study was designed to evaluate the degree of placenta share discordance in relation to the betamethasone-induced return of positive end-diastolic flow in monochorionic twin pregnancies with selective intrauterine growth restriction (sIUGR) and abnormal umbilical artery Doppler. Monochorionic twins with sIUGR was defined as one twin having an estimated fetal weight below the 10th percentile combined with an estimated fetal weight discordance >25%. The umbilical artery Doppler directly prior to (D0) and 24 hours (D1) and 48 hours (D2) after the first dose of betamethasone administration was recorded. The estimated individual placental weight in monochorionic twins was obtained by cutting the placenta along the vascular equator into two territories; the placenta share discordance was calculated as [(estimated individual placental weight of appropriated for gestational age twin-estimated individual placental weight of growth restricted twin)/estimated individual placental weight of appropriated for gestational age twin] × 100%. Six (23.1%) of the 26 included cases achieved betamethasone-induced return of positive umbilical artery end-diastolic flow. The difference of placenta share discordance and birth weight discordance were not significantly different between twins with and without betamethasone-induced return of positive umbilical artery end-diastolic flow. Thus, according to our study results, it was proposed that although the placenta share discordance correlated with the abnormal umbilical artery Doppler in the IUGR fetus in monochorionic twin, the betamethasone-induced return of positive umbilical artery end-diastolic flow, however, did not reveal the similar relationship with the severity of placenta share discordance.

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“…Three studies have shown that fetuses with AEDV often show a transient improvement in blood flow after glucocorticoid administration, and fetuses that did not show improvement appeared to have poorer outcomes [17][18][19].…”

Section: Therapy For Treatment Of Fgrmentioning

confidence: 99%

Current Trends in Management of Fetal Growth Restriction

Gujral¹,

Nayar

2014

Journal of Fetal Medicine

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Fetal growth restriction (FGR) or intrauterine growth restriction (IUGR) are the terms used for a fetus which has not attained its full growth potential. FGR fetus is associated with high perinatal and neonatal morbidity and mortality, besides long term neurological handicap because of in utero hypoxia. Three decades of research has indicated that almost all treatment strategies are ineffective in treating FGR. Panorama of management includes identifying women at risk, correct dating, distinguishing between a constitutionally small and a true FGR, monitoring for fetal hypoxia, growth, and a timely intervention to avoid death or damage.

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Predicting Perinatal Outcome Through Changes in Umbilical Artery Doppler Studies After Antenatal Corticosteroids in the Growth-restricted Fetus

Cited by 13 publications

References 0 publications

The effects of intrauterine growth restriction and antenatal glucocorticoids on ovine fetal lung development

The effects of intrauterine growth restriction and antenatal glucocorticoids on ovine fetal lung development

Placenta Share Discordance and Umbilical Artery Doppler Change After Antenatal Betamethasone Administration in Monochorionic Twins With Selective Intrauterine Growth Restriction: Is There a Link?

Current Trends in Management of Fetal Growth Restriction

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