UTICAJ DIREKTNE INTRAMUSKULARNE KORTIKOSTEROIDNE TERAPIJE NA VENSKU CIRKULACIJU KOD FETUSA U HIPOKSIJI

Abstract

Introduction The influence of glucocorticosteroid therapy on foetal lung maturation is evident but little is known about its effects on parameters of foetal venous circulation.

Objective The aim of the study was to assess the influence of direct intramuscular (i.m.) foetal corticosteroid therapy (CST) on parameters of foetal venous circulation which indicates a degree of foetal hypoxia.

Method The prospective study was conducted at the Institute of Gynaecology and Obstetrics during 2001.We evaluated the influence of direct i.m. foetal single dose dexamethasone (2 mg/ kg estimated foetal weight by sonographic examination) on foetal ductus venosus (DV) and vena cava inferior (VCI) velocities in 49 foetuses 24 hours before and after therapy.

Results There is positive correlation with the statistical significance in systolic/diastolic ratio (S/D) in DV before and after the corticotherapy r=0.366; p=0.018. Reverse flow during contraction of the right atrium in DV was found in 55.6% of foetuses after CST. Reverse flow during the contraction of the right atrium in VCI was found in 3 foetuses before CST and in 4 foetuses after CST. We found positive correlation without statistical significance between the vena cava pre-load indices before and after CST (r=0.127; p= 0.428). There is positive correlation with the statistical significance between systolic flow in VCI before and after CST (r=0.478; p=0.002).

Conclusion Corticosteroid therapy influences parameters of foetal venous circulation. Its influence depends on duration of foetal hypoxia. The parameters of foetal venous circulation can be a predictor of the perinatal outcome.

Keywords: foetal corticosteroid therapy; venous velocities; hypoxia