The effect of glucocorticosteroid administration on fetal movements and biophysical profile scores in normal pregnancies.

OBJECTIVE: To evaluate and quantify the effect of glucocorticosteroid administration on fetal movements and biophysical profile scores. METHODS: Eighteen women at 32-34 weeks' gestation were enrolled. Inclusion criterion was an uncomplicated singleton pregnancy not considered to be at high risk. Patients participated for 3 consecutive days. On day 1, the patients underwent a baseline biophysical profile including a non-stress test followed by a 12-mg betamethasone intramuscular injection. On day 2, the patients received a non-stress test and a second dose of betamethasone. On day 3, a biophysical profile with non-stress test was performed. Maternal counts of fetal kicks were also recorded before, during and after the study period. Each test was conducted at approximately the same time of day to control for diurnal variation. Comparison was made between pre-betamethasone biophysical profile scores and fetal movement and post-betamethasone biophysical profile scores and fetal movement. RESULTS: Biophysical profile scores were reduced in 28% of the study population after betamethasone administration (p < 0.05). Amniotic fluid index on day 3 was decreased from baseline in 72% of patients after betamethasone administration (p < 0.05). Forty-four per cent of patients reported a decrease in fetal movement. Of these patients, 87% had a decreased amniotic fluid index when compared to baseline (p < 0.05). CONCLUSIONS: Fetal movements and breathing motion were decreased after glucocorticosteroid administration, as evidenced by biophysical profile scores and kick counts. The decrease in the amniotic fluid index observed after glucocorticosteroid administration may have been the result of decreased fetal breathing and, therefore, decreased efflux of alveolar fluid into the amniotic sac.

Correlation of quantitative protein measurements in 8-, 12-, and 24-hour urine samples for the diagnosis of preeclampsia.

OBJECTIVE: The purpose of this study is to determine if a patient's 8- and/or 12-hour urine total protein values correlate with the 24- hour value to confirm the diagnosis of preeclampsia. STUDY DESIGN: The study population included 65 patients with hypertensive disorders of pregnancy. Patients' urine was collected over 24 hours with the first 8 hours, next 4 hours, and remaining 12 hours collected in separate containers. The urine volume, and total protein and creatinine levels were measured in the 8-, 12-, and 24-hour samples. The 8- and 12-hour results were compared to the 24-hour results by use of simple regression analysis. RESULTS: Of the 65 patients, 20 had no proteinuria, 37 had mild proteinuria, and 8 had severe proteinuria. The results of the 8- hour sample correlated with those of the 24-hour sample for patients with mild (P <.001) and severe disease (P =.003). The 12-hour sample correlated with the 24-hour sample for patients with no disease (P <.001), mild proteinuria (P <.001), and severe proteinuria (P =.0003). CONCLUSION: Total protein values for 8- and 12-hour urine samples correlate positively with values for 24-hour samples for patients with proteinuria. The results for 12- and 24-hour samples correlate for patients without proteinuria.