Imperial College London
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Professor Christoph Lees, MD FRCOG

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Obstetrics
 
 
 
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Contact

 

+44 (0)20 7594 5770c.lees

 
 
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Assistant

 

Ms Hazel Blackman +44 (0)20 7594 2104

 
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Location

 

Queen Charlottes and Chelsea HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Fratelli:2021:10.1055/a-0972-1098,
author = {Fratelli, N and Prefumo, F and Wolf, H and Hecher, K and Visser, GHA and Giussani, D and Derks, JB and Shaw, CJ and Frusca, T and Ghi, T and Ferrazzi, E and Lees, CC and TRUFFLE, Group and TRUFFLE, Group authors and TRUFFLE, Group collaborating authors},
doi = {10.1055/a-0972-1098},
journal = {European Journal of Ultrasound / Ultraschall in der Medizin},
pages = {56--64},
title = {Effects of antenatal betamethasone on fetal doppler indices and short term fetal heart rate variation in early growth restricted fetuses},
url = {http://dx.doi.org/10.1055/a-0972-1098},
volume = {42},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - PURPOSE:  To investigate the effects of the antenatal administration of betamethasone on fetal Doppler and short term fetal heart rate variation (CTG-STV) in early growth restricted (FGR) fetuses. MATERIALS AND METHODS:  Post hoc analysis of data derived from the TRUFFLE study, a prospective, multicenter, randomized management trial of severe early onset FGR. Repeat Doppler and CTG-STV measurements between the last recording within 48 hours before the first dose of betamethasone (baseline value) and for 10 days after were evaluated. Multilevel analysis was performed to analyze the longitudinal course of the umbilico-cerebral ratio (UC ratio), the ductus venosus pulsatility index (DVPIV) and CTG-STV. RESULTS:  We included 115 fetuses. A significant increase from baseline in CTG-STV was found on day +1 (p=0.019) but no difference thereafter. The DVPIV was not significantly different from baseline in any of the 10 days following the first dose of betamethasone (p=0.167). Multilevel analysis revealed that, over 10 days, the time elapsed from antenatal administration of betamethasone was significantly associated with a decrease in CTG-STV (p=0.045) and an increase in the DVPIV (p=0.001) and UC ratio (p<0.001). CONCLUSION:  Although steroid administration in early FGR has a minimal effect on increasing CTG-STV one day afterwards, the effects on Doppler parameters were extremely slight with regression coefficients of small magnitude suggesting no clinical significance, and were most likely related to the deterioration with time in FGR. Hence, arterial and venous Doppler assessment of fetal health remains informative following antenatal steroid administration to accelerate fetal lung maturation.
AU  - Fratelli,N
AU  - Prefumo,F
AU  - Wolf,H
AU  - Hecher,K
AU  - Visser,GHA
AU  - Giussani,D
AU  - Derks,JB
AU  - Shaw,CJ
AU  - Frusca,T
AU  - Ghi,T
AU  - Ferrazzi,E
AU  - Lees,CC
AU  - TRUFFLE,Group
AU  - TRUFFLE,Group authors
AU  - TRUFFLE,Group collaborating authors
DO  - 10.1055/a-0972-1098
EP  - 64
PY  - 2021///
SN  - 0172-4614
SP  - 56
TI  - Effects of antenatal betamethasone on fetal doppler indices and short term fetal heart rate variation in early growth restricted fetuses
T2  - European Journal of Ultrasound / Ultraschall in der Medizin
UR  - http://dx.doi.org/10.1055/a-0972-1098
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31476786
UR  - http://hdl.handle.net/10044/1/78512
VL  - 42
ER  -
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