en اثرات کوتاه مدت بتامتازن دوران بارداری بر سیستم قلبی عروقی و گردش خون جنینی: یک مطالعه شبه تجربی (قبل و بعد) Perinatology Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">تجویز کورتیکو استرویید آنته ناتال، یک درمان استاندارد برای کاهش عوارض مرگ</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">و&shy;میر پره&shy;ناتال است، گرچه شواهد کمی مبنی بر اثرات انقباضی بتامتازون برمجرای شریانی وجود دارد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مطالعه حاضر با هدف بررسی اثرات کوتاه مدت بتامتازون آنته ناتال بر وضعیت قلبی عروقی و گردش خون جنین انجام شده است.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش&shy; ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">یک مطالعه شبه تجربی (قبل و بعد) بر روی 32 جنین تک قلو انجام شد. شرکت&shy;کنندگان در مطالعه شامل، زنان باردار سالم با تشخیص طیفی از جفت اکرتا و واجد شرایط دریافت 2 دز بتامتازون که به کلینیک مراقبت&shy;های بارداری بیمارستان ولی&shy;عصر تهران، ایران از ژانویه 2021 تا می 2022 مراجعه کرده بودند. نتایج آزمایشات اکوکاردیوگرافی و سونوگرافی داپلر، قبل و پس از تزریق کورتیکواستروئید آنته ناتال بین شرکت&shy;کنندگان مقایسه شد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">پس از تزریق بتامتازون، افزایش معنی&shy;داری در حداکثر سرعت سیستولی و دیاستولی مجرای شریانی، بدون انقباض در مجرا ایجاد شد (به ترتیب&nbsp;&nbsp;&nbsp;&nbsp; 002/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> و 001/0</span></span> <span dir="LTR" style="font-size:10.0pt"><</span> <span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">). همچنین تغییر معنی&shy;داری در عملکرد بطن راست، دریچه سه لتی، داپلر مجرای وریدی، و حداکثر سرعت ایسموس آئورت دیده نشد (05/0 </span></span><span dir="LTR" style="font-size:10.0pt">></span> <span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">). تغییرات معنی&shy;داری در داپلر شریان&shy;های رحمی، نافی و میانی مغزی نیز مشاهده نشد (05/0 </span></span><span dir="LTR" style="font-size:10.0pt">></span> <span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">).</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy; گیری: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">با توجه به فواید درمان با کورتیکواستروئید آنته ناتال، تجویز آن در زایمان زودرس به&shy;نظر منطقی می&shy;رسد. به&shy;نظر نمی&shy;رسد تغییرات گذرا در جریان خون مجرای شریانی مشاهده شده پس از تجویز، عامل بازداره تلقی گردد.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span></div> <div style="text-align: justify;"><span style="font-size:10pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><b><span style="font-size:12.0pt">Background: </span></b><span style="font-size:12.0pt">The administration of antenatal corticosteroid is a standard treatment to reduce the rate of perinatal mortality and morbidity; however, there is limited evidence regarding the potential effects of betamethasone on the constriction of the ductus arteriosus (DA).</span></span></span></span><br> <span style="font-size:10pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><b><span style="font-size:12.0pt">Objective: </span></b><span style="font-size:12.0pt">This study aimed to investigate the short-term effects of antenatal betamethasone on fetal cardiovascular and circulation status.</span></span></span></span><br> <span style="font-size:10pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><b><span style="font-size:12.0pt">Materials and Methods: </span></b><span style="font-size:12.0pt">This quasi-experimental observational (</span><span style="font-size:12.0pt">before-after) study was conducted </span><span style="font-size:12.0pt">on 32 singleton fetuses. The participants were healthy pregnant women with a diagnosis of placenta accreta spectrum who were eligible for 2 doses of betamethasone and referred to prenatal care clinic, Vali-E-Asr hospital, Tehran, Iran </span><span style="font-size:12.0pt">from </span><span style="font-size:12.0pt">January 2021-</span><span style="font-size:12.0pt">May 2022. </span><span style="font-size:12.0pt">The results of fetal echocardiography and Doppler sonography were compared before and after the administration of antenatal corticosteroid therapy.</span></span></span></span><br> <span style="font-size:10pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><b><span style="font-size:12.0pt">Results:</span></b><span style="font-size:12.0pt"> Following betamethasone injection, significant increases were observed in peak systolic and diastolic velocity of the DA without constriction of the DA (p < 0.001, p = 0.002 respectively). However, no significant changes were observed in right ventricular function, tricuspid valve function, Doppler of ductus venous, and peak systolic velocity of the aortic isthmus (p > 0.05). Doppler examination of the uterine, umbilical, and middle cerebral arteries also showed no significant changes (p > 0.05).</span></span></span></span><br> <span style="font-size:10pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><b><span style="font-size:12.0pt">Conclusion:</span></b><span style="font-size:12.0pt"> Considering the benefits of antenatal corticosteroid therapy, its administration seems reasonable in preterm births. The transient changes in ductal blood flow are not prohibitive.</span></span></span></span></div> بتامتازون, زایمان زودرس, سونوگرافی, داپلر, اکوکاردیوگرافی, جنین. Betamethasone, Premature birth, Ultrasonography, Doppler, Echocardiography, Fetus. 375 382 http://ijrm.ir/browse.php?a_code=A-10-2591-1&slc_lang=en&sid=1 Sedigheh Hantoushzadeh sedighehhantoushzadeh3@gmail.com 0000-0003-3779-9218 No Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Amir Amiri dr.amiri202@gmail.com 0009-0002-9186-0606 No Maternal, Fetal, and Neonatal Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Azadeh Shabani Azadeshabani@sbmu.ac.ir 0000-0002-0438-0982 No Preventative Gynecology Research Center (PGRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Yasamin Soufi Enayati Yasamin.soufi@gmail.com 0009-0002-6033-3109 No Psychology Department, University of Science and Culture, Tehran, Iran. Neda Mostafaeipour mostafaei.neda@yahoo.com 0000-0002-3484-4194 No Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran. Seyede Houra Mousavi Vahed vahedalainh@mums.ac.ir 0009-0000-9250-6305 No Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran. Maria Nezamnia Mariane.zamnia@gmail.com 0009-0006-3363-7990 No Department of Gynecology, School of Medicine, Pasteur Hospital, Bam University of Medical Sciences, Bam, Iran. Toktam Sheykhian toktamsheykhian@gmail.com 0000-0001-7108-9186 Yes Maternal, Fetal, and Neonatal Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.