Effect of dexamethasone and betamethasone on fetal heart rate variability in preterm labour: a randomised study.
OBJECTIVE
To compare the effects of betamethasone and dexamethasone on fetal heart rate in appropriately grown fetuses.


METHODS
Eighty-two pregnant women (97 fetuses) with preterm labour were randomly allocated to receive betamethasone (n=42) or dexamethasone (n=40) for fetal lung maturation in a nonblinded fashion. Computerised cardiotocogram (CTG) parameters were compared before, during and after treatment.


RESULTS
A decrease in fetal heart rate variability was found with betamethasone but no significant changes were found with dexamethasone. Fetal heart rate variability returned to pre-treatment values within a week after cessation of treatment with betamethasone. Neonatal outcome was similar in the two groups.


CONCLUSIONS
These findings might prove useful in the management of compromised fetuses with decreased fetal heart rate variability in which the CTG should be used together with other parameters to assess fetal wellbeing during corticosteroid treatment. Dexamethasone may be preferable as the drug of choice since it was associated with significantly less alteration in fetal heart rate variability compared with betamethasone.
Unité de Médecine Foetale, Hôpital Béclère, Clamart, France.
M V
MV
Senat
S
S
Minoui
O
O
Multon
H
H
Fernandez
R
R
Frydman
Y
Y
Ville
D001623:Betamethasone / Q000627:therapeutic use*; D001724:Birth Weight; D015148:Cardiotocography; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D005325:Fetal Organ Maturity; D005865:Gestational Age; D005938:Glucocorticoids / Q000627:therapeutic use*; D006340:Heart Rate, Fetal / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000196:embryology; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011446:Prospective Studies
D005938:Glucocorticoids; D003907:Dexamethasone; D001623:Betamethasone