Maternal Steroids on Fetal Doppler Indices, in Growth-Restricted Fetuses with Abnormal Umbilical Flow from Pregnancies Complicated with Early-Onset Severe Preeclampsia
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TICA, Oana Sorina, TICĂ, Andrei Adrian, COJOCARU, Doriana, TICA, Irina, PETCU, Lucian Cristian, COJOCARU, Victor, ALEXANDRU, Dragos Ovidiu, TICA, Vlad Iustin. Maternal Steroids on Fetal Doppler Indices, in Growth-Restricted Fetuses with Abnormal Umbilical Flow from Pregnancies Complicated with Early-Onset Severe Preeclampsia. In: Diagnostics, 2023, vol. 13, pp. 1-12. ISSN -. DOI: https://doi.org/10.3390/diagnostics13030428
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Diagnostics
Volumul 13 / 2023 / ISSN - /ISSNe 2075-4418

Maternal Steroids on Fetal Doppler Indices, in Growth-Restricted Fetuses with Abnormal Umbilical Flow from Pregnancies Complicated with Early-Onset Severe Preeclampsia

DOI:https://doi.org/10.3390/diagnostics13030428

Pag. 1-12

Tica Oana Sorina1, Tică Andrei Adrian12, Cojocaru Doriana34, Tica Irina56, Petcu Lucian Cristian5, Cojocaru Victor4, Alexandru Dragos Ovidiu1, Tica Vlad Iustin65
 
1 University of Medicine and Pharmacy Craiova,
2 Emergency Clinical County Hospital of Craiova,
3 ”Nicolae Testemițanu” State University of Medicine and Pharmacy,
4 Timofei Moșneaga Republican Clinical Hospital,
5 Ovidius University, Constanța,
6 Regional Emergency Hospital of Constanta
 
 
Disponibil în IBN: 23 februarie 2023


Rezumat

Corticoids are largely used for fetal interest in expected preterm deliveries. This study went further, evaluating the effect of maternal administration of dexamethasone (Dex) on the umbilical artery (UA), middle cerebral artery (MCA), and ductus venous (DV) spectrum, in growth-restricted fetuses, with the absent end-diastolic flow (AEDF) in UA, from singleton early-onset severe preeclamptic pregnancies. Supplementary, the impact on both uterine arteries (UTAs) flow was also evaluated. In 68.7% of cases, the EDF was transiently restored (trAEDF group), in the rest of 31.2% remained persistent absent (prAEDF group). UA-PI significantly decreased in the first day after Dex (day 1/0; p < 0.05), reaching its minimum during day 2 (day 2/1; p > 0.05), revealing a significant recovery to day 4 (day 4/2; p < 0.05), in both groups. The MCA-PI decreased from day 1 until day 3 in both groups, but significantly only in the trAEDF group (p = 0.030 vs. p = 0.227. The DV-PI’s decrease (during day 1) and the CPR’s increase (between days 0 and 2) were not significant in both groups. UTAs-PIs did not vary. The prAEDF group had a significantly increased rate of antenatal worsening Doppler and a poorer perinatal outcome compared with the trAEDF group. In conclusion, Dex transiently restored the AEDF in UA in the majority of cases, a “positive” effect being a useful marker for better perinatal prognosis. UA-PI significantly decreased in all cases. The improvement in umbilical circulation probably was responsible for the short but not significant DV-PI reduction. MCA-PI decreased only in sensitive cases, probably due to an already cerebral “full” vasodilation in the prAEDF group. Furthermore, the CPR’s nonsignificant improvement was the result of a stronger effect of Dex on UA-PI than on MCA-PI. Finally, despite the same etiology, it was only a weak correlation between the severity of the umbilical and uterine abnormal spectrum.

Cuvinte-cheie
cerebroplacental ratio, dexamethasone, doppler fetal indices, ductus venosus, middle cerebral artery, pulsatility index, umbilical artery, uterine arteries