Cargando…
Maternal Steroids on Fetal Doppler Indices, in Growth-Restricted Fetuses with Abnormal Umbilical Flow from Pregnancies Complicated with Early-Onset Severe Preeclampsia
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, w...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914710/ https://www.ncbi.nlm.nih.gov/pubmed/36766533 http://dx.doi.org/10.3390/diagnostics13030428 |
_version_ | 1784885730557820928 |
---|---|
author | Tica, Oana Sorina Tica, Andrei Adrian Cojocaru, Doriana Tica, Irina Petcu, Cristian Lucian Cojocaru, Victor Alexandru, Dragos Ovidiu Tica, Vlad Iustin |
author_facet | Tica, Oana Sorina Tica, Andrei Adrian Cojocaru, Doriana Tica, Irina Petcu, Cristian Lucian Cojocaru, Victor Alexandru, Dragos Ovidiu Tica, Vlad Iustin |
author_sort | Tica, Oana Sorina |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9914710 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-99147102023-02-11 Maternal Steroids on Fetal Doppler Indices, in Growth-Restricted Fetuses with Abnormal Umbilical Flow from Pregnancies Complicated with Early-Onset Severe Preeclampsia Tica, Oana Sorina Tica, Andrei Adrian Cojocaru, Doriana Tica, Irina Petcu, Cristian Lucian Cojocaru, Victor Alexandru, Dragos Ovidiu Tica, Vlad Iustin Diagnostics (Basel) Article 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. MDPI 2023-01-24 /pmc/articles/PMC9914710/ /pubmed/36766533 http://dx.doi.org/10.3390/diagnostics13030428 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Tica, Oana Sorina Tica, Andrei Adrian Cojocaru, Doriana Tica, Irina Petcu, Cristian Lucian 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 |
title | Maternal Steroids on Fetal Doppler Indices, in Growth-Restricted Fetuses with Abnormal Umbilical Flow from Pregnancies Complicated with Early-Onset Severe Preeclampsia |
title_full | Maternal Steroids on Fetal Doppler Indices, in Growth-Restricted Fetuses with Abnormal Umbilical Flow from Pregnancies Complicated with Early-Onset Severe Preeclampsia |
title_fullStr | Maternal Steroids on Fetal Doppler Indices, in Growth-Restricted Fetuses with Abnormal Umbilical Flow from Pregnancies Complicated with Early-Onset Severe Preeclampsia |
title_full_unstemmed | Maternal Steroids on Fetal Doppler Indices, in Growth-Restricted Fetuses with Abnormal Umbilical Flow from Pregnancies Complicated with Early-Onset Severe Preeclampsia |
title_short | Maternal Steroids on Fetal Doppler Indices, in Growth-Restricted Fetuses with Abnormal Umbilical Flow from Pregnancies Complicated with Early-Onset Severe Preeclampsia |
title_sort | maternal steroids on fetal doppler indices, in growth-restricted fetuses with abnormal umbilical flow from pregnancies complicated with early-onset severe preeclampsia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914710/ https://www.ncbi.nlm.nih.gov/pubmed/36766533 http://dx.doi.org/10.3390/diagnostics13030428 |
work_keys_str_mv | AT ticaoanasorina maternalsteroidsonfetaldopplerindicesingrowthrestrictedfetuseswithabnormalumbilicalflowfrompregnanciescomplicatedwithearlyonsetseverepreeclampsia AT ticaandreiadrian maternalsteroidsonfetaldopplerindicesingrowthrestrictedfetuseswithabnormalumbilicalflowfrompregnanciescomplicatedwithearlyonsetseverepreeclampsia AT cojocarudoriana maternalsteroidsonfetaldopplerindicesingrowthrestrictedfetuseswithabnormalumbilicalflowfrompregnanciescomplicatedwithearlyonsetseverepreeclampsia AT ticairina maternalsteroidsonfetaldopplerindicesingrowthrestrictedfetuseswithabnormalumbilicalflowfrompregnanciescomplicatedwithearlyonsetseverepreeclampsia AT petcucristianlucian maternalsteroidsonfetaldopplerindicesingrowthrestrictedfetuseswithabnormalumbilicalflowfrompregnanciescomplicatedwithearlyonsetseverepreeclampsia AT cojocaruvictor maternalsteroidsonfetaldopplerindicesingrowthrestrictedfetuseswithabnormalumbilicalflowfrompregnanciescomplicatedwithearlyonsetseverepreeclampsia AT alexandrudragosovidiu maternalsteroidsonfetaldopplerindicesingrowthrestrictedfetuseswithabnormalumbilicalflowfrompregnanciescomplicatedwithearlyonsetseverepreeclampsia AT ticavladiustin maternalsteroidsonfetaldopplerindicesingrowthrestrictedfetuseswithabnormalumbilicalflowfrompregnanciescomplicatedwithearlyonsetseverepreeclampsia |