Study of changes in non-stress test following antenatal corticosteroid therapy in preterm pregnancy

Authors

  • Renuka S. Department of Obstetrics and Gynecology, Chettinad Hospital and Research Institute, Kelambakkam, Kanchipuram District, Tamil Nadu, India
  • Sathiya S. Department of Obstetrics and Gynecology, Chettinad Hospital and Research Institute, Kelambakkam, Kanchipuram District, Tamil Nadu, India
  • Famida A. M. Department of Obstetrics and Gynecology, Chettinad Hospital and Research Institute, Kelambakkam, Kanchipuram District, Tamil Nadu, India
  • Vijayalakshmi K. Department of Obstetrics and Gynecology, Chettinad Hospital and Research Institute, Kelambakkam, Kanchipuram District, Tamil Nadu, India
  • Sailatha R. Department of Obstetrics and Gynecology, Chettinad Hospital and Research Institute, Kelambakkam, Kanchipuram District, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20194870

Keywords:

Antenatal, Corticosteroid, Betamethasone, Foetal movements, Non-stress test, Preterm

Abstract

Background: Preterm birth is the largest unsolved problem in obstetrics and the single most significant cause of neonatal morbidity and mortality. Preterm labour constitutes 5-10% of pregnancies and is the leading cause of neonatal morbidity and mortality worldwide. It is a major public health problem in terms of loss of life, long term disability (cerebral palsy, blindness, deafness, chronic lung disease). The objectives of this study were to determine whether antenatal corticosteroid administration affects the non-stress test. To evaluate the effect of antenatal steroid on foetal movements. To assess the incidence of respiratory distress syndrome and neonatal mortality after antenatal corticosteroid administration.

Methods: All antenatal cases between 28-32 weeks of gestation judged to be at risk for preterm delivery attending the outpatient department or admitted in a tertiary care hospital, Tamil Nadu during the study period of 3 years.

Results: The present study was undertaken to evaluate the NST for a period of 3 days following antenatal corticosteroid administration and to study the immediate changes in the mother and the foetus. We found out that there was a statistically significant change (p <0.01) in non-stress test when compared with the pre-betamethasone assay.

Conclusions: Corticosteroids can cause metabolic alterations in mother, short- and long-term effect in the foetus.

References

Howson CP, Kinney MV, Lawn J. March of Dimes, PMNCH, Save the Children. Born Too Soon: the global action report on preterm birth. WHO; 2012.

Spong CY. Defining term pregnancy: recommendations from the Defining “Term” Pregnancy Workgroup. JAMA. 2013;309:2445-6.

Antepartum foetal surveillance, In: Practice Bulletin 9. American College of Obstetrics and Gynecology; 1999.

Vintzileos AM. Antenatal assessment for the detection of fetal asphyxia: an evidence-based approach using indicating-specific testing. Ann NY Acad Sci. 2000;90:137-50.

Renou P, Warwick N, Wood C. Autonomic control of foetal heart rate. Am J Obstet Gynecol. 1969;105:949.

Myrick T, Harper DM. Principles of nonstress testing in pregnancy. J Family Pract. 1996;43:443-8.

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. BJOG: An Int J Obstet Gynaecol. 1998;105(7):749-55.

Rotmensch S, Liberati M, Vishne T, Celentano C, Ben-Rafael Z, Bellati U. The effect of betamethasone and dexamethasone on fetal heart rate patterns and biophysical activities, A prospective randomized trial. Acta Obstetr Gynecol Scandinavica. 1999;78(6):493-500.

Liggins GC. Howie RN. Prevention of respiratory distress syndrome in premature infants by antepartum glucocorticoid treatment. In: Villee CA, Villee DB, Zuckerman J eds. Respiratory distress syndrome. London: Academic press; 1973:369-380.

Howie RN, Liggins GC. Clinical trials of antepartum Betamethasone for prevention of respiratory distress in preterm infants. In: Preterm labour: Proceedings of the fifth study group of the Royal College of Obstetricians and Gynecologists London; 1977:281-289.

Crowley P. Prophylactic corticosteroids for preterm birth. Cochrane Database Syst Rev. 2000;(2):CD000065.

National institutes of health consensus developement conference statement. Am J Obstet Gynecol. 1995;173:246-52.

ACOG Committee Opinion. Committee on Obstetric Practice: Antenatal corticosteroid therapy for fetal lung maturation. 1994:147.

National Institutes of Health Consensus Development Conference Statement. Antenatal corticosteroids revisited: repeat courses. 2000.

Hon EH, Quiligan EJ. The classification of foetal heart rate. Conn Med. 1967;31:779-84.

Kelly MK, Schneider EP, Petrikovsky BM, Lesser ML. Effect of antenatal steroid administration on the foetal biophysical profile. J Clin Ultrasound. 2000;28:224-6.

Mulder EJ. Transient reduction in foetal activity and heart rate variability after maternal Betamethasone administration. Early Hum Dev. 1994;36(1):49-60.

Downloads

Published

2019-10-23

Issue

Section

Original Research Articles