Effect of antenatal administration of thyrotrophin releasing hormone on fetal flow velocity waveforms
Institute of Obstetrics and Gynaecology,
Royal Postgraduate Medical School, Queen
Charlotte's and Chelsea Hospital, Goldhawk Road,
London W6 0XG
Correspondence to: Dr Rekha Bajoria. email: r.bajoria{at}rpms.ac.uk
Accepted 3 April 1997
AIM
To determine whether antenatal administration
of thyrotrophin releasing hormone (TRH), to promote lung maturation,
alters blood flow through the fetal middle cerebral, umbilical artery, or ductus arteriosus and through the maternal uterine arteries.
METHODSThe effect of transplacentally
administered TRH on the fetal circulation was prospectively evaluated
in 30 patients between 24 and 34 weeks' gestation. TRH (400 µg) was
given to the mother intravenously either as a bolus or an infusion.
Fetal effects were determined by measuring the maximum velocity and
pulsatility index (PI) in middle cerebral artery, ductus arteriosus,
uterine artery and umbilical artery Doppler waveforms. Measurements
were made immediately before, and 10 and 60 minutes after maternal TRH administration.
RESULTSIntravenous injection of TRH had no
significant effect on PI in the uterine, umbilical, or middle cerebral
artery and the ductus arteriosus within 60 minutes of administration in
either group.
CONCLUSIONThe antenatal use of TRH in conjunction
with steroids for fetal lung maturity does not affect utero-placental
or fetal haemodynamic variables, as measured by Doppler. These
findings, therefore, do not support the suggestion that antenatal
intravenous administration of TRH either as bolus or infusion may have
immediate adverse vascular effects in the fetus.
© 1997 by Archives of Disease in Childhood
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