Antenatal steroid
Antenatal steroids are steroids given before birth. Betamethasone and dexamethasone are used with the intention to help the lungs of a premature fetus develop before the fetus comes out.[1] They are given when the fetus is expected to be delivered within 24 to 48 hours. Treatment consists of 2 doses of 12 mg of betamethasone given intramuscularly 24 hours apart or 4 doses of 6 mg of dexamethasone given intramuscularly 12 hours apart. Optimal benefit begins 24 hours after initiation of therapy and lasts 7 days. [2] Betamethasone is preferred over dexamethasone because it is thought to have better prophylaxis of brain softening of premature fetus.[3] Antenatal steroids are currently used up to 36 weeks in some parts of the world obstetric practice. [4]
It may also reduce risk of intraventricular hemorrhage.[5]
The time between administration of steroids and delivery may alter the effectiveness of the steroids.[6]
References
- ^ Engle WA (February 2008). "Surfactant-replacement therapy for respiratory distress in the preterm and term neonate". Pediatrics 121 (2): 419–32. doi:10.1542/peds.2007-3283. PMID 18245434. http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=18245434.
- ^ "Medscape Obstetrics". http://www.medscape.com/viewarticle/408941_9.
- ^ "Antenatal Steroid Video". http://www.ovguide.com/antenatal-steroid-9202a8c04000641f8000000000862be6#.
- ^ "UK National Health Service". http://www.nelm.nhs.uk/en/NeLM-Area/News/2011---April/132/Antenatal-corticosteroids-at-34-36-weeks-gestation-do-not-appear-to-reduce-incidence-of-respiratory-disorders-in-late-preterm-infants.
- ^ Abbasi S, Oxford C, Gerdes J, Sehdev H, Ludmir J (January 2010). "Antenatal Corticosteroids Prior to 24 Weeks' Gestation and Neonatal Outcome of Extremely Low Birth Weight Infants". Am J Perinatol 27 (1): 61–66. doi:10.1055/s-0029-1223269. PMID 19544249. http://www.thieme-connect.com/DOI/DOI?10.1055/s-0029-1223269.
- ^ McEvoy C, Schilling D, Spitale P, Peters D, O'Malley J, Durand M (May 2008). "Decreased respiratory compliance in infants less than or equal to 32 weeks' gestation, delivered more than 7 days after antenatal steroid therapy". Pediatrics 121 (5): e1032–8. doi:10.1542/peds.2007-2608. PMID 18450845. http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=18450845.