Comparison of Effect of Antenatal Dexamethasone Versus Betamethasone on Antepartum Cardiotocography

Abstract

Objective: To compare the outcome of antenatal dexamethasone versus betamethasone on antepartum cardiotocography in terms of mean number of accelerations and long-term variability at day 0, 2 and 4 following drug administration

Methodology: This single blind Randomized Controlled Trial was carried out at Department of Obstetrics & Gynecology, Holy Family Hospital, Rawalpindi from 13th July 2025 to 15th October 2025. The trial was registered with clinicaltrials.gov (NCT07078786). The study enrolled 110 patients with 55 in each group. In Group A, patients received a 24 mg intramuscular injection of dexamethasone, administered as two doses of 12 mg 24 hours apart. In diabetic patients, the total dose was administered in four equal divided doses 12 hours apart. In Group B, patients received a 24 mg intramuscular injection of betamethasone, administered as two doses of 12 mg 24 hours apart.

Results: Baseline characteristics were comparable between groups (all p>0.05). Acceleration counts were similar at baseline (p=0.881) but were significantly higher in the dexamethasone group at day 4 (p<0.001), with significant within-group decline from baseline in both groups (p<0.001). Fetal heart rate variability was significantly better with dexamethasone at day 2 (p=0.006) and day 4 (p=0.013).

Conclusion: Administration of both Dexamethasone and Betamethasone to mother causes transient decrease in both fetal heart rate accelerations and variability with greater effect seen in case of Betamethasone