Background: Antenatal administration of corticosteroids has been recommended as it promotes fetal lung maturation, reduces the incidence and severity of respiratory distress syndrome and other complications. The objective of present study was to study the effect of antenatal betamethasone administration on fetoplacental circulation on Doppler ultrasonography, in preterm pregnancies with fetal growth restriction and the effect of fetoplacental circulation changes on perinatal outcome.

Material and Methods: This prospective study was carried out on 80 pregnant women, with gestational age from 28 – 34 weeks, with intrauterine growth restriction. Color Doppler blood flow study of fetal vessels including umbilical artery,  middle cerebral artery and ductus venosus as well as both maternal uterine  arteries was done, once before and twice after betamethasone administration and a comparative evaluation was done.

Results: There was a statistically significant difference between all Doppler indices in umbilical artery, fetal middle cerebral artery and ductus venosus before and 24 hours after maternal betamethasone administration. No significant effect on maternal uterine arteries was observed. Neonates of women who showed an improvement in umbilical artery PI had significantly lesser requirement of assisted resuscitative measures, better Apgar at 1, 5, and 10 min and required lesser admissions to Neonatal Intensive Care Unit, as compared to neonates of women who did not show any decrease in umbilical artery PI.

Conclusion: Maternal betamethasone administration significantly affects fetal circulation but not in all cases with IUGR. So, Doppler study done before and one day after betamethasone administration in pregnancies complicated with IUGR can enable us to identify the subgroup of IUGR cases, who are at higher risk of adverse perinatal outcome. 

Keywords: Intrauterine growth restriction (IUGR), betamethasone, respiratory distress syndrome.

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Dr Renu Jain

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