obstetrics gynecology

Antenatal steroids
1. Dose
The National Institutes of Health (NIH) Consensus Panel and the ACOG recommends

A) dexamethansone 4 mg IM × every 12 hours, for 4 doses for all women in preterm labor between 24 and 34 weeks’ gestation.

B ) betamethansone 12 mg IM × 2 doses, 24 hours apart if more than 2 weeks had passed and the gestational age was less than 33 weeks.

# Corticosteroids are not recommended for use in pregnant women who are at more than 34 weeks’ gestation unless there is an indication of fetal lung immaturity.

2. Role
facilitate fetal lung maturation by increasing production of fetal lung surfactant, thereby reducing the incidence and severity of RDS,Antenatal corticosteroid also decreases the incidence of intraventricular hemorrhage, necrotizing enterocolitis, and neonatal death

3. Important notes
A) The greatest reduction in RDS occurs when delivery can be delayed 24 hours up to 7 days after starting treatment.

B ) Betamethasone, however, might be the preferred agent because fewer IM injections are needed and because in meta analysis it was associated with a greater reduction in RDS compared with dexamethasone.
also in the reduction of periventricular leukomalacia, a finding associated with later risks for cerebral palsy.

4. Warning
Repeated weekly corticosteroid courses should not be given because of the association with decreased birth weight and head circumference, hypothalamic- pituitary-adrenal axis suppression, deleterious effects on cerebral myelination and lung growth, and neonatal death .

#Ben_Ali
@obstetricsgynecology1

www.tgoop.com/obstetricsgynecology1/310

20.1K viewsApr 4, 2020 at 15:39

Antenatal steroids
1. Dose
The National Institutes of Health (NIH) Consensus Panel and the ACOG recommends

A) dexamethansone 4 mg IM × every 12 hours, for 4 doses for all women in preterm labor between 24 and 34 weeks’ gestation.

B ) betamethansone 12 mg IM × 2 doses, 24 hours apart if more than 2 weeks had passed and the gestational age was less than 33 weeks.

# Corticosteroids are not recommended for use in pregnant women who are at more than 34 weeks’ gestation unless there is an indication of fetal lung immaturity.

2. Role
facilitate fetal lung maturation by increasing production of fetal lung surfactant, thereby reducing the incidence and severity of RDS,Antenatal corticosteroid also decreases the incidence of intraventricular hemorrhage, necrotizing enterocolitis, and neonatal death

3. Important notes
A) The greatest reduction in RDS occurs when delivery can be delayed 24 hours up to 7 days after starting treatment.

B ) Betamethasone, however, might be the preferred agent because fewer IM injections are needed and because in meta analysis it was associated with a greater reduction in RDS compared with dexamethasone.
also in the reduction of periventricular leukomalacia, a finding associated with later risks for cerebral palsy.

4. Warning
Repeated weekly corticosteroid courses should not be given because of the association with decreased birth weight and head circumference, hypothalamic- pituitary-adrenal axis suppression, deleterious effects on cerebral myelination and lung growth, and neonatal death .

#Ben_Ali
@obstetricsgynecology1

BY obstetrics gynecology