Effect of dexamethasone on daily fetal movement, umbilical and middle cerebral arteries Doppler and cardiotocogram


  • Ahmed Alanwar Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt
  • Sherif Akl Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt
  • Sherif Hanafi Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt
  • Nader Mohamed Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt




Dexamethasone, Fetal movement, Middle cerebral artery Doppler, Umbilical artery Doppler


Background: Preterm birth is a leading cause of perinatal death and disability and is an important public health problem globally. There is more work to be done regarding steroids effect, especially with the variations among demography and pathological conditions affecting mothers. The aim of this study was to investigate the effect of dexamethasone on healthy fetuses, observing the effects on MCA and UA Doppler velocity waveforms and cardiotocography, correlating them with fetal movement.

Methods: This prospective cross-sectional study was conducted in Ain Shams University Maternity Hospital, starting from April 2020 till December 2020. One hundred and ten women was recruited for the study. All women undergo elective cesarean section before 39 weeks of gestation. UA and MCA Doppler values were taken; nonstress test was recorded and fetal movements were counted after a single course of dexamethasone.

Results: Our results included decrease in MCA PI, decrease in foetal movement count on the second day of dexamethasone injection, increase of short-term variability and direct correlation between the MCA RI and UA PI with the fetal movements decrease on the 5th day of dexamethasone injection.

Conclusions: There are definitely cardiovascular changes that occur after dexamethasone administration, presented by increase in MCA blood flow and increase in FHR short term variability.



Roberts D, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2016;(3):CD004454.

Crowther CA, Harding JE. Repeat doses of prenatal corticosteroids for women at risk of preterm birth for preventing neonatal respiratory disease. Cochrane Database Syst Rev. 2007;3:CD003935.

Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome. Pediatrics. 2002;50:515.

Maršál KS, Gennser S, Ohrlander AV. Fetal and neonatal breathing movements in man after betamethasone. Life Sci. 2009;17:449-54.

Katz MI, Meizner IS, Holcberg GE, Mazor MO, Hagay ZJ, Insler VA. Reduction or cessation of fetal movements after administration of steroids for enhancement of lung maturation. I. Clinical evaluation. Israel J Med Sci. 1988;24(1):5-9.

Doyle LW, Ehrenkranz RA, Halliday HL. Dexamethasone treatment in the first week of life for preventing bronchopulmonary dysplasia in preterm infants: a systematic review. Neonatol. 2010;98(3):217-24.

Wapner RJ, Sorokin Y, Thom EA, Johnson F, Dudley DJ, Spong CY, et al. Single versus weekly courses of antenatal corticosteroids: Evaluation of safety and efficacy. Am J Obstet Gynecol. 2006;195:633.

Jackson JR, Kleeman S, Doerzbacher M, Lambers DS. The effect of glucocorticosteroid administration on fetal movements and biophysical profile scores in normal pregnancies. J Matern Fet Neonat Med. 2003;13:50-3.

ACOG Practice Bulletin Number 145: Antepartum Fetal Surveillance, July 2014. Obstet Gynecol. 2014;124:182-92.

Sadovsky E. Monitoring fetal movement: A useful screening test. Contemp Obstet Gynecol. 1985;25(4):123-35.

Senat MV, Minoui S, Multon O, Fernandez H, Frydman R, Ville Y. Effect of dexamethasone and betamethasone on fetal heart rate variability in preterm labour: a randomised study. Br J Obstet Gynaecol. 2008;105:749-55.

Baud O, Foix-L'Helias L, Kaminski M, Audibert F, Jarreau PH, Papiernik E, et al. Antenatal glucocorticoid treatment and cystic periventricular leukomalacia in very premature infants. New Engl J Med. 2009;341:1190.

Rushmer RF, Baker DW, Johnson WL, Strandness DE. Clinical applications of a transcutaneous ultrasonic flow detector. JAMA. 2007;199(5):326-8.

Chitrit Y, Caubel P, Herrero R, Schwinte AL, Guillaumin D, Boulanger MC. Effects of maternal dexamethasone administration on fetal Doppler flow velocity waveforms. BJOG. 2010;107(4):501-7.

Urban R, Lemancewicz A, Przepieść J, Urban J, Kretowska M. Antenatal corticosteroid therapy: a comparative study of dexamethasone and betamethasone effects on fetal Doppler flow velocity waveforms. Eur J Obstet Gynecol Reprod Biol. 2005;120:170-4.

Senat MV, Ville Y. Effect of steroids on arterial Doppler in intrauterine growth retardation fetuses. Fetal Diagn Ther. 2015;15:36-40.

Fukuda S, Kato T, Kakita H, Yamada Y, Hussein MH, Kato I, et al. Hemodynamics of the cerebral arteries of infants with periventricular leukomalacia. Pediatrics. 2016;117(1):1-8.

Subtil D, Tiberghien P, Devos P, Therby D, Leclerc G, Vaast P, et al. Immediate and delayed effects of antenatal corticosteroids on fetal heart rate: a randomized trial that compares betamethasone acetate, betamethasone phosphate, and dexamethasone. Am J Obstet Gynecol. 2013;188:524-31.

Magee LA, Dawes GS, Moulden M, Redman CWG. A randomised controlled comparison of betamethasone with dexamethasone: effects on the antenatal fetal heart rate. Br J Obstet Gynaecol. 2012;104:1233-8.

Mushkat Y, Ascher-Landsberg J, Keidar R, Carmon E, Pauzner D, David MP. The effect of betamethasone versus dexamethasone on fetal biophysical parameters. Eur J Obstet Gynecol Reprod Biol. 2011;97:50-2.

Multon O, Senat MV, Minoui S, Hue MV, Frydman R, Ville Y. Effect of antenatal betamethasone and dexamethasone administration on fetal heart rate variability in growth-retarded fetuses. Fet Diagn Ther. 2013;12:170-7.

Dawes GS. Breathing before birth in animals and man. An essay in medicine. Physiol Med. 2004;290:557.

Derks JB, Mulder EJH, Visser GHA. The effects of maternal betamethasone administration on the fetus. Br J Obstet Gynaecol. 2010;102:40-6.

Rotmensch S, Lev S, Kovo M, Efrat Z, Zahavi Z, Lev N, et al. Effect of betamethasone administration on fetal heart rate tracing: a blinded longitudinal study. Fet Diagn Ther. 2012;20:371-6.

Jacobs BL. Overview of the activity of brain monoaminergic neurons across the sleep-wake cycle. In: Wauquicr A, Monti JM, Gaillard JM, eds. Sleep: neurotransmitters and neuromodulators. 1st edn. Raven Press; 1985:1-4.

Pearson JF, Weaver JB. Fetal activity and fetal wellbeing: an evaluation. Br Med J. 2006;1:1305-7.






Original Research Articles