Joy Weyrich1, Anna Setter2, Alexander Müller3, Georg Schmidt3, Christine E Brambs4, Javier U Ortiz4, Silvia M Lobmaier4. 1. Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany. Electronic address: joy.weyrich@tum.de. 2. Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany; Department of Neurology, Klinikum Leverkusen, Leverkusen, Germany. 3. I. Medizinische Klinik, Technische Universität München, Munich, Germany. 4. Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany.
Abstract
OBJECTIVE: To analyze the effect of maternal betamethasone given for fetal lung maturation on fetal short-term variation (STV) and average acceleration and deceleration capacity (AAC/ADC). Both of these factors are calculated by phase-rectified signal averaging (PRSA) and represent new parameters to assess the fetal autonomic nervous system. STUDY DESIGN: A longitudinal prospective study including 26 pregnant women at risk for preterm delivery was performed. Two injections of 12mg betamethasone were administered intramuscularly at a 24h interval for lung maturation. Cardiotocography recordings were performed at defined time intervals: day 0 (before the first injection) and days 1, 2, 4 after the first corticosteroid administration. AAC/ADC and STV were calculated. RESULTS: An increase of all parameters (STV, AAC and ADC) was documented between day 0 and day 1. Between day 1 and day 2, all three indices were significantly reduced (p<0.05). STV declined by 19.8%, AAC by 10.1% and ADC by 14.8%. A normalization of these values was seen after 96h. CONCLUSION: Similar to STV, AAC/ADC shows significant changes after maternal betamethasone administration. The corticosteroid-induced transient decrease of the levels needs to be taken into account in the assessment of the fetal status to avoid misinterpretation of these parameters.
OBJECTIVE: To analyze the effect of maternal betamethasone given for fetal lung maturation on fetal short-term variation (STV) and average acceleration and deceleration capacity (AAC/ADC). Both of these factors are calculated by phase-rectified signal averaging (PRSA) and represent new parameters to assess the fetal autonomic nervous system. STUDY DESIGN: A longitudinal prospective study including 26 pregnant women at risk for preterm delivery was performed. Two injections of 12mg betamethasone were administered intramuscularly at a 24h interval for lung maturation. Cardiotocography recordings were performed at defined time intervals: day 0 (before the first injection) and days 1, 2, 4 after the first corticosteroid administration. AAC/ADC and STV were calculated. RESULTS: An increase of all parameters (STV, AAC and ADC) was documented between day 0 and day 1. Between day 1 and day 2, all three indices were significantly reduced (p<0.05). STV declined by 19.8%, AAC by 10.1% and ADC by 14.8%. A normalization of these values was seen after 96h. CONCLUSION: Similar to STV, AAC/ADC shows significant changes after maternal betamethasone administration. The corticosteroid-induced transient decrease of the levels needs to be taken into account in the assessment of the fetal status to avoid misinterpretation of these parameters.
Authors: Carolina López-Justo; Adriana Cristina Pliego-Carrillo; Claudia Ivette Ledesma-Ramírez; Hugo Mendieta-Zerón; Miguel Ángel Peña-Castillo; Juan Carlos Echeverría; Jorge Rodríguez-Arce; José Javier Reyes-Lagos Journal: Sensors (Basel) Date: 2021-12-10 Impact factor: 3.576