Intramuscular fetal corticosteroid therapy: short-term effects on the fetus

Fetal Diagn Ther. 2009;25(1):98-101. doi: 10.1159/000203398. Epub 2009 Feb 25.

Abstract

Objective: The aim of the study was to assess the short-term effects of direct intramuscular (i.m.) corticosteroid therapy on fetal biophysical profile, baseline fetal heart rate and the nonstress test, which indicate the degree of fetal hypoxia.

Method: We evaluated the effect of direct i.m. fetal single-dose dexamethasone (4 mg/kg) on the fetal biophysical profile 2 h before and 2-4 h after corticosteroid therapy in 41 fetuses in the 32nd week of gestation at risk of preterm delivery. Risk factors for preterm delivery included pregnancy-induced hypertension and preeclampsia.

Result: There was a statistically significant difference between fetal breathing movements before and after corticosteroid therapy (p = 0.019; 95% confidence interval for difference -11.75, -1.12). No significant changes were observed between baseline fetal heart rate before and after corticosteroid therapy (p = 0.99; 95% confidence interval for difference -4.81, +4.81), biophysical profile before and after fetal corticosteroid therapy, p = 0.235 as well as the nonstress test before and after therapy (p = 0.564).

Conclusion: Direct corticosteroid i.m. fetal therapy results in increasing profound short-term fetal breathing movements. There are no changes in baseline fetal heart rate, biophysical profile score, and nonstress test.

MeSH terms

  • Adult
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects*
  • Female
  • Fetal Hypoxia / chemically induced*
  • Fetus / drug effects*
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects*
  • Heart Rate, Fetal / drug effects*
  • Humans
  • Injections, Intramuscular
  • Pregnancy
  • Respiration / drug effects

Substances

  • Glucocorticoids
  • Dexamethasone