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Updated: Jan 4, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Improvement of cardiac function in fetuses with growth restriction following antenatal betamethasone administration:
Priyadarshini Vadivelu1, Anish Keepanasseril1, Nishad Plakkal2
1Department of Obstetrics & Gynaecology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, India.
Insights
Betamethasone administration improved fetal heart rate and cardiac function in fetuses with FGR. Further studies are needed to confirm long-term benefits for growth-restricted fetuses.
Area of Science:
- Perinatal Medicine
- Fetal Cardiology
- Reproductive Endocrinology
Background:
- Corticosteroids enhance fetal lung maturation, reducing prematurity complications.
- Limited research exists on steroid effects on fetal circulation and cardiac function in Fetal Growth Restriction (FGR).
Purpose of the Study:
- To evaluate changes in fetal Doppler indices and cardiovascular function following betamethasone administration in pregnancies complicated by FGR.
Main Methods:
- Prospective study of 50 FGR pregnancies (28-36 weeks gestation) receiving betamethasone.
- Fetal cardiovascular function assessed pre- and post-betamethasone using Doppler indices.
- Statistical analysis included Wilcoxon matched-pairs signed-rank test or paired t-tests.
Main Results:
- Betamethasone improved fetal heart rate (p < .001) and left/right heart Myocardial Performance Index (MPI) (p ≤ .001, p = .016).
- Significant improvements were noted in left heart isovolumic relaxation/contraction indices and ejection times (p < .001).
- Other fetal cardiac and Doppler indices remained unchanged post-steroid administration.
Conclusions:
- Betamethasone administration positively impacts fetal heart rate and cardiac MPI in FGR fetuses.
- Long-term persistence and clinical benefits of these effects in growth-restricted fetuses require further investigation.
Introduction:
Use of corticosteroids for fetal lung maturation has reduced the perinatal mortality/morbidity from prematurity related complications. There is a paucity of studies evaluating the effect of steroid administration on the fetal circulation and cardiac function in fetal growth restriction (FGR). The aim of the study was to assess changes in fetal Doppler indices and cardiovascular function in pregnancies complicated with FGR after administration of betamethasone.
Methods:
This was a prospective study conducted in a tertiary care research center between July 2017 and May 2018. Pregnant women with FGR between 28 and 36 weeks' gestation, who were scheduled to receive betamethasone (two doses of 12 mg, 24 h apart) were recruited. Fetal cardiovascular function in fetuses FGR was assessed immediately before first dose and once between 6 and 24 h after the second dose of betamethasone by the same operator. Wilcoxon matched-pairs signed-rank test or paired t-tests were used to compare parameters before and after corticosteroid exposure.
Results:
Fifty cases with FGR were evaluated before and after administration of betamethasone, at mean gestational age of 34.6 ± 2.0 weeks. Fetal heart rate (148.78 ± 9.10 versus 144.73 ± 9.61, p < .001), left heart myocardial performance index ([MPI], 0.66 ± 0.06 versus 0.55 ± 0.09, p ≤ .001) and right heart MPI (0.65 ± 0.04 versus 0.63 ± 0.04, p .016) showed improvement after steroids. Left heart isovolumic relaxation and contraction indices along with ejection time of both sides showed a small but statistically significant improvement (p < .001), but other fetal cardiac functional and Doppler indices remain unchanged after steroids.
Conclusions:
Fetal heart rate, cardiac MPI, left sided isovolumic indices showed an improvement after betamethasone administration. Follow up studies are needed to ascertain whether these effects persist in the long term and to determine whether these are beneficial to a growth restricted fetuses.
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