Kardiovaskuläre hämodynamische Veränderungen nach antenatalenKortikosteroiden bei Feten mit intrauteriner Wachstumsretar-dierung und bei zeitgerecht entwickelten Feten

Laura Marchi; Lucia Pasquini; Ayten Elvan-Taşpınar; Caterina Maddalena Bilardo

doi:10.1055/a-0654-4824

Kardiovaskuläre hämodynamische Veränderungen nach antenatalenKortikosteroiden bei Feten mit intrauteriner Wachstumsretar-dierung und bei zeitgerecht entwickelten Feten

Translated title of the contribution: Cardiovascular Hemodynamic Changes After Antenatal Corticosteroids in Growth Restricted and Appropriate for Gestational Age Fetuses

Laura Marchi^*, Lucia Pasquini, Ayten Elvan-Taşpınar, Caterina Maddalena Bilardo

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

PURPOSE: To investigate hemodynamic effects after antenatal corticosteroids (ACS) administration in appropriate for gestational age (AGA) and early growth restricted (GR) fetuses by measurement of Doppler cardiovascular function parameters.

MATERIALS AND METHODS: Prospective cohort study. AGA and GR singleton pregnancies receiving ACS for fetal lung maturation between 24 + 0 - 33 + 6 weeks were enrolled. Feto-placental vascular hemodynamics were studied by: umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, renal artery (RenA) PI. Cardiac function was evaluated by ductus venosus (DV) PI and by echocardiographic parameters: E to A wave ratios (E/A) and mitral and tricuspid annular plane systolic excursion (MAPSE and TAPSE) for diastolic function, left and right myocardial performance index (MPI) for overall (diastolic and systolic) function. A single operator performed all the measurements at 3 different time points (E): E0 before or within 4 hours of ACS administration (baseline examination), E1 24 - 48 hours after the first dose and E2 7 days after the second dose of ACS. The values were expressed as z-scores. Pairwise comparisons with paired t-test were performed to compare measurements before and after exposure to ACS.

RESULTS: 25 AGA and 20 GR fetuses (mean gestational age: 31 + 1 and 30 + 6, respectively) were included in the analysis. In the AGA group ACS administration was associated with a significant reduction in UA PI. In the GR fetuses ACS temporarily (E0-E1) restored UA-end diastolic flow (EDF) in 6 of 9 fetuses with A/R-EDF ("Return of EDF phenomenon") and produced a significant increase (worsening) in right MPI (both in E1-E2 and in E0-E2).

CONCLUSION: ACS administration is associated with UA vasodilation in both AGA and GR fetuses and with an increase in right MPI in the latter group. This suggests a worsening in cardiac function in GR fetuses.

Translated title of the contribution	Cardiovascular Hemodynamic Changes After Antenatal Corticosteroids in Growth Restricted and Appropriate for Gestational Age Fetuses
Original language	German
Pages (from-to)	292-299
Number of pages	8
Journal	Ultraschall in der Medizin
Volume	41
Issue number	3
Early online date	26-Aug-2018
DOIs	https://doi.org/10.1055/a-0654-4824
Publication status	Published - 1-Jun-2020

Keywords

obstetrics
doppler
antenatal corticosteroids
fetal growth restriction

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10.1055/a-0654-4824

Cardiovascular Hemodynamic Changes After Antenatal Corticosteroids in Growth Restricted and Appropriate for Gestational Age FetusesFinal publisher's version, 247 KBLicence: Taverne

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@article{2dac9d3792994ac4b345ab00b9c4c1d2,

title = "Kardiovaskul{\"a}re h{\"a}modynamische Ver{\"a}nderungen nach antenatalenKortikosteroiden bei Feten mit intrauteriner Wachstumsretar-dierung und bei zeitgerecht entwickelten Feten",

abstract = "PURPOSE: To investigate hemodynamic effects after antenatal corticosteroids (ACS) administration in appropriate for gestational age (AGA) and early growth restricted (GR) fetuses by measurement of Doppler cardiovascular function parameters.MATERIALS AND METHODS: Prospective cohort study. AGA and GR singleton pregnancies receiving ACS for fetal lung maturation between 24 + 0 - 33 + 6 weeks were enrolled. Feto-placental vascular hemodynamics were studied by: umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, renal artery (RenA) PI. Cardiac function was evaluated by ductus venosus (DV) PI and by echocardiographic parameters: E to A wave ratios (E/A) and mitral and tricuspid annular plane systolic excursion (MAPSE and TAPSE) for diastolic function, left and right myocardial performance index (MPI) for overall (diastolic and systolic) function. A single operator performed all the measurements at 3 different time points (E): E0 before or within 4 hours of ACS administration (baseline examination), E1 24 - 48 hours after the first dose and E2 7 days after the second dose of ACS. The values were expressed as z-scores. Pairwise comparisons with paired t-test were performed to compare measurements before and after exposure to ACS.RESULTS: 25 AGA and 20 GR fetuses (mean gestational age: 31 + 1 and 30 + 6, respectively) were included in the analysis. In the AGA group ACS administration was associated with a significant reduction in UA PI. In the GR fetuses ACS temporarily (E0-E1) restored UA-end diastolic flow (EDF) in 6 of 9 fetuses with A/R-EDF ({"}Return of EDF phenomenon{"}) and produced a significant increase (worsening) in right MPI (both in E1-E2 and in E0-E2).CONCLUSION: ACS administration is associated with UA vasodilation in both AGA and GR fetuses and with an increase in right MPI in the latter group. This suggests a worsening in cardiac function in GR fetuses.",

keywords = "obstetrics, doppler, antenatal corticosteroids, fetal growth restriction",

author = "Laura Marchi and Lucia Pasquini and Ayten Elvan-Ta{\c s}pınar and Bilardo, {Caterina Maddalena}",

note = "{\textcopyright} Georg Thieme Verlag KG Stuttgart · New York.",

year = "2020",

month = jun,

day = "1",

doi = "10.1055/a-0654-4824",

language = "German",

volume = "41",

pages = "292--299",

journal = "Ultraschall in der Medizin ",

issn = "0172-4614",

publisher = "GEORG THIEME VERLAG KG",

number = "3",

}

Kardiovaskuläre hämodynamische Veränderungen nach antenatalenKortikosteroiden bei Feten mit intrauteriner Wachstumsretar-dierung und bei zeitgerecht entwickelten Feten. / Marchi, Laura; Pasquini, Lucia; Elvan-Taşpınar, Ayten et al.
In: Ultraschall in der Medizin , Vol. 41, No. 3, 01.06.2020, p. 292-299.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Kardiovaskuläre hämodynamische Veränderungen nach antenatalenKortikosteroiden bei Feten mit intrauteriner Wachstumsretar-dierung und bei zeitgerecht entwickelten Feten

AU - Marchi, Laura

AU - Pasquini, Lucia

AU - Elvan-Taşpınar, Ayten

AU - Bilardo, Caterina Maddalena

PY - 2020/6/1

Y1 - 2020/6/1

N2 - PURPOSE: To investigate hemodynamic effects after antenatal corticosteroids (ACS) administration in appropriate for gestational age (AGA) and early growth restricted (GR) fetuses by measurement of Doppler cardiovascular function parameters.MATERIALS AND METHODS: Prospective cohort study. AGA and GR singleton pregnancies receiving ACS for fetal lung maturation between 24 + 0 - 33 + 6 weeks were enrolled. Feto-placental vascular hemodynamics were studied by: umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, renal artery (RenA) PI. Cardiac function was evaluated by ductus venosus (DV) PI and by echocardiographic parameters: E to A wave ratios (E/A) and mitral and tricuspid annular plane systolic excursion (MAPSE and TAPSE) for diastolic function, left and right myocardial performance index (MPI) for overall (diastolic and systolic) function. A single operator performed all the measurements at 3 different time points (E): E0 before or within 4 hours of ACS administration (baseline examination), E1 24 - 48 hours after the first dose and E2 7 days after the second dose of ACS. The values were expressed as z-scores. Pairwise comparisons with paired t-test were performed to compare measurements before and after exposure to ACS.RESULTS: 25 AGA and 20 GR fetuses (mean gestational age: 31 + 1 and 30 + 6, respectively) were included in the analysis. In the AGA group ACS administration was associated with a significant reduction in UA PI. In the GR fetuses ACS temporarily (E0-E1) restored UA-end diastolic flow (EDF) in 6 of 9 fetuses with A/R-EDF ("Return of EDF phenomenon") and produced a significant increase (worsening) in right MPI (both in E1-E2 and in E0-E2).CONCLUSION: ACS administration is associated with UA vasodilation in both AGA and GR fetuses and with an increase in right MPI in the latter group. This suggests a worsening in cardiac function in GR fetuses.

AB - PURPOSE: To investigate hemodynamic effects after antenatal corticosteroids (ACS) administration in appropriate for gestational age (AGA) and early growth restricted (GR) fetuses by measurement of Doppler cardiovascular function parameters.MATERIALS AND METHODS: Prospective cohort study. AGA and GR singleton pregnancies receiving ACS for fetal lung maturation between 24 + 0 - 33 + 6 weeks were enrolled. Feto-placental vascular hemodynamics were studied by: umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, renal artery (RenA) PI. Cardiac function was evaluated by ductus venosus (DV) PI and by echocardiographic parameters: E to A wave ratios (E/A) and mitral and tricuspid annular plane systolic excursion (MAPSE and TAPSE) for diastolic function, left and right myocardial performance index (MPI) for overall (diastolic and systolic) function. A single operator performed all the measurements at 3 different time points (E): E0 before or within 4 hours of ACS administration (baseline examination), E1 24 - 48 hours after the first dose and E2 7 days after the second dose of ACS. The values were expressed as z-scores. Pairwise comparisons with paired t-test were performed to compare measurements before and after exposure to ACS.RESULTS: 25 AGA and 20 GR fetuses (mean gestational age: 31 + 1 and 30 + 6, respectively) were included in the analysis. In the AGA group ACS administration was associated with a significant reduction in UA PI. In the GR fetuses ACS temporarily (E0-E1) restored UA-end diastolic flow (EDF) in 6 of 9 fetuses with A/R-EDF ("Return of EDF phenomenon") and produced a significant increase (worsening) in right MPI (both in E1-E2 and in E0-E2).CONCLUSION: ACS administration is associated with UA vasodilation in both AGA and GR fetuses and with an increase in right MPI in the latter group. This suggests a worsening in cardiac function in GR fetuses.

KW - obstetrics

KW - doppler

KW - antenatal corticosteroids

KW - fetal growth restriction

U2 - 10.1055/a-0654-4824

DO - 10.1055/a-0654-4824

M3 - Article

C2 - 30366353

SN - 0172-4614

VL - 41

SP - 292

EP - 299

JO - Ultraschall in der Medizin

JF - Ultraschall in der Medizin

IS - 3

ER -

Kardiovaskuläre hämodynamische Veränderungen nach antenatalenKortikosteroiden bei Feten mit intrauteriner Wachstumsretar-dierung und bei zeitgerecht entwickelten Feten

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