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Fetal Heart Rate Variability Before and After Antenatal Corticosteroids in Patients at High Risk of Preterm Labor

Background: Premature birth (PTB) occurs in one in ten pregnancies. There are about 13 million PTBs annually worldwide. Antenatal corticosteroids are administered to enhance fetal lung maturation in cases of threatened preterm delivery between 24- and 34-weeks’ gestational age (GA). 
Objective: This study aimed to study the cardiotocograp (CTG) before and after antenatal corticosteroids administration in patients at high risk of preterm labor to reduce preterm risks. 
Patients and Methods: A prospective cohort study included 52 women who were at risk of premature birth. Each woman received the recommended course of corticosteroids consists of 4 doses of dexamethasone 6 mg for 48 hours (Dexamethasone 8 ml intramuscularly, 12 h apart). CTG examination: Fetal heart rate was monitored with fetal monitor cardiotocogram machine. Cardiotocography strips were interpreted visually. 
Results: In our study we recorded decrease in baseline fetal heart rate and increase in fetal heart rate variability (LTV, STV) after dexamethasone course by 24 hours, which were statistically significant. The number of accelerations showed a slight increase, which was significant. Decelerations were not present at all before or after the course. The STV showed a significant change before the course, all participants had moderate STV, but after the course, 8 (15.4%) showed marked variability, which was significant. We found that most of participants (90.4%) had decreased fetal kicks after injection relying on maternal perception. 
Conclusion:     There was a decrease in baseline fetal heart rate and increase in fetal heart rate variability (LTV, STV) after dexamethasone course by 24 hours, which were statistically significant. The number of accelerations showed a slight increase, which was significant.