Antenatal steroid

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Antenatal steroids (or antenatal corticosteroids) are medications given to pregnant women expecting preterm delivery. They have been shown to reduce the morbidity and mortality of hyaline membrane disease.[1] They have also been shown to have definite beneficial effect even in conditions of preterm premature rupture of membranes (PPROM).[2] Dexamethasone and betamethasone are the corticosteroids used for the purpose although the former is recommended over the latter based on its efficacy, safety, wide availability, and low cost[3] in spite of some counter-logic.[4] Betamethasone, on the other hand, is preferred over dexamethasone because it is thought to have better prophylaxis of brain softening of premature fetus.[5] They are used with the intention to help the lungs of a premature fetus develop before the fetus comes out.[6] 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.[7][8] Antenatal steroids are currently used up to 36 weeks in some parts of the world obstetric practice.[9]

It may also reduce risk of intraventricular hemorrhage.[10][11]

The time between administration of steroids and delivery may alter the effectiveness of the steroids.[12]

References

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  3. "Dexamethasone versus betamethasone as an antenatal corticosteroid (ACS)" (PDF). UN Commission / Born Too soon Care Antenatal Corticosteroids Working Group. August 20, 2013. Retrieved 6 January 2014.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
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  5. "Antenatal Steroid Video".<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
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  7. "Recommendations for Use of Antenatal Corticosteroids". perinatology.com. Retrieved 6 January 2014.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  8. "Medscape Obstetrics".<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>(subscription required)
  9. "UK National Health Service".<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
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Further reading