Doppler Changes Before and After Antenatal Corticosteroids in Patients at High Risk of Preterm Labor

Abstract

Background:Preterm labor is an obstetrics emergency, a leading cause of perinatal death and disability and is an important public health problem globally. 75% of infant mortality is related to preterm labor. Doppler ultrasound is used as a part of clinical protocol in surveillance of high-risk pregnancies. It gives direct information of feto-placental circulation and identifies placental circulatory failure. This study aimed to study the Doppler changes before and after antenatal corticosteroids administration in patients high risk of preterm labor to reduce preterm risks.Methods:The current study was a prospective cohort study. which conducted at the Obstetrics and Gynecology Department, Zagazig University hospital. The study included 52 women who were at risk of premature birth with uncomplicated singleton pregnancies between 29 and 36 weeks of pregnancy. Each participant underwent obstetric history taking, physical examination and laboratory investigations to fulfill.Dexamethasone treatment: Each woman received the recommended course of corticosteroids consists of 4 doses dexamethasone 6mg for 48 hrs. (Dexamethasone 8 ml, Sigma) intramuscularly 12 h apart. Doppler studies were performed just before dexamethasone administration and repeated 24 h after completion of the dexamethasone course. Outcome of the study was detection of changes in Doppler indices before and after dexamethasone administration. Results: Dexamethasone administration was found to have a beneficial effect on fetuses at risk for preterm birth as evident by the decrease in the Doppler indices of umbilical artery and MCA.  Umbilical artery Pulsatility and Resistance Doppler indices showed a statistically significant decrease after 24 hours of taking dexamethasone. For the correlation coefficients, our research revealed that there was statistically significant negative correlation between gestational age with umbilical and middle cerebral artery SD and pulsatility indices while regarding umbilical and middle cerebral arteries resistance index, there was no significant correlation with gestational age. Conclusion: Dexamethasone administration was found to have a beneficial effect on fetuses at risk for preterm birth as evident by the decrease in the Doppler indices of umbilical artery and MCA.Umbilical artery Pulsatility and Resistance Doppler indices showed a statistically significant decrease after 24 hours of taking dexamethasone and there was statistically significant decrease on MCA Pulsatility and Resistance indices.