Effect of Antenatal Corticosteroid on Cardiotocographic Parameters in Pregnant Women

Objective: To evaluate the effect of dexamethasone administration on cardiotocographic parameters. Material & Methods: A prospective cohort study was carried out in the department of Obstetrics and Gynaecology in collaboration with Department of physiology, Jawaharlal Nehru Medical College & Hospital. Total 100 pregnant women between gestational age of 28 weeks to 38 weeks were enrolled in the study. They underwent cardiotocography on day 0 i.e. before administration of injection dexamethasone, on day 2 (after 48 hours of first dose) and on day 4-7. Patients received injection dexamethasone 6 mg i.m. 4 doses at an interval of 12 hours for various indications like preterm labor (PTL), preterm prelabor rupture of membrane (PPROM), placenta previa and previous CS. Outcome  measures were changes in Baseline FHR(Fetal Heart Rate), Baseline variability, Acceleration and DFMC before and after dexamethasone administration. Results: All parameters including Baseline FHR, Accelerations, baseline variability and daily fetal movement counts were significantly reduced on day 2 of injection dexamethasone administration and returned to baseline values after 4 to 7 days of receiving dexamethasone. Conclusions: Dexamethasone administration resulted in transient reduction in baseline FHR, acceleration, variability and DFMC that mimic fetal compromise, hence clinicians should be aware of this phenomena to avoid iatrogenic preterm delivery of the fetus.