title: Direct intramuscular fetal or maternal antenatal corticosteroid therapy: short-time effects on fetal behavior and oxygenation: a comparative study.
abstract: OBJECTIVE
  To compare the effects of antenatal administration of corticosteroids used in two different regimens, on fetal biophysical profile (BPP), baseline fetal heart rate (BFHR), nonstress test (NST) and perinatal outcomes.
  
  
  METHODS
  We evaluated the effects of single direct intramuscular (i.m.) fetal dose of dexamethasone (4 mg/kg), or four doses of 6 mg dexamethasone given to the mother 12 hours apart on the parameters of fetal BPP 0-4 hours before and after antenatal contraction stress (ACST). We evaluated two groups of 41 fetuses in the 31st gestation week at risk of fetal hypoxia at the Department of Gynecology/Obstetrics, Clinical Center of Serbia in 2013.
  
  
  RESULTS
  In fetal ACST group, we found significantly different changes in fetal breathing movement before (D0-f) and after therapy (D1-f), p  =  0.019 (-11.75; -1.12), 95% confidence interval (CI), as well as in the maternal ACST group, p  =  0.001; (-11.75; -1.12), 95% CI. We found significant difference between BPP 0-m and BPP1-m in the maternal group, p =  0.000. Neonatal asphyxia occurred more often with the increased frequency of fetal breath movements after both ACST (p  =  0.04 versus p  =  0.07).
  
  
  CONCLUSIONS
  Fetal ACST results in increased fetal breathing movements. Maternal ACST can result in changes to BPP. The increase in fetal breathing movements determinates neonatal asphyxia regardless of the ACST.
authors.affiliation: a Department of Gynecology and Obstetrics , Clinical Center of Serbia, School of Medicine, University of Belgrade , Belgrade , Serbia .
authors.forename: Ivana
authors.initials: I
authors.lastname: Babović
authors.affiliation: b Faculty of Organizational Sciences , Institute for Statistics, University of Belgrade , Belgrade , Serbia , and.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Radojičić
authors.affiliation: a Department of Gynecology and Obstetrics , Clinical Center of Serbia, School of Medicine, University of Belgrade , Belgrade , Serbia .
authors.forename: Snežana
authors.initials: S
authors.lastname: Plešinac
authors.affiliation: a Department of Gynecology and Obstetrics , Clinical Center of Serbia, School of Medicine, University of Belgrade , Belgrade , Serbia .
authors.forename: Biljana
authors.initials: B
authors.lastname: Kastratović Kotlica
authors.affiliation: c Department of Gynecology and Obstetrics , Clinical Center of Serbia , Belgrade , Serbia.
authors.forename: Radmila
authors.initials: R
authors.lastname: Sparić
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005324:Fetal Movement / Q000187:drug effects*; D046128:Fetal Therapies / Q000379:methods*; D005333:Fetus / Q000187:drug effects*; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage*; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D007273:Injections, Intramuscular; D008168:Lung / Q000196:embryology*; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D012119:Respiration / Q000187:drug effects; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control; D016216:Ultrasonography, Prenatal
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Antenatal corticosteroid therapy; biophysical profile; fetal corticosteroid therapy; fetal heart rate; nonstress test