Dexamethasone was associated with no significant changes in fetal heart rate variability, whereas betamethasone caused a decrease in pregnant women with preterm labour.
RCT (n=82)
Open-label
randomly allocated
Does dexamethasone compared to betamethasone prevent alterations in fetal heart rate variability in pregnant women with preterm labour?
Dexamethasone may be preferable to betamethasone for fetal lung maturation as it avoids the transient decrease in fetal heart rate variability, simplifying fetal assessment.
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.
Sénat et al. (Wed,) conducted a rct in preterm labour (n=82). Dexamethasone vs. Betamethasone was evaluated on Fetal heart rate variability. Dexamethasone was associated with no significant changes in fetal heart rate variability, whereas betamethasone caused a decrease in pregnant women with preterm labour.