Am J Obstet Gynecol. J Pediatr 2011;159:110–114.e1. [, Roberts D, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Obstet Gynecol 2007;109:634–40. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented. Specific data on the use of corticosteroids in the periviable period are supported by a combination of laboratory data on the response of lung tissue and clinical observational studies 1 2 17 18. The use of antenatal corticosteroid administration after preterm PROM has been evaluated in a number of clinical trials and has been shown to reduce neonatal mortality, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis 6 12 19 20. Antenatal glucocorticoids are widely used in obstetrics for pregnancies at risk for early preterm delivery. Results: A woman in premature labor is prescribed betamethasone to enhance fetal lung maturity. American College of Obstetricians and Gynecologists. Treatment with 1 dose of intramuscular betamethasone-acetate 0.125mg/kg improved dynamic and static lung compliance, gas exchange, and ventilation efficiency similarly to the standard treatment of 2 doses of 0.25 m/kg of betamethasone-acetate+betamethasone-phosphate. Quality improvement strategies to optimize appropriate and timely antenatal corticosteroid administration are encouraged. 170. The role of antenatal corticosteroids in twin pregnancies complicated by preterm birth. The Maternal Fetal Medicine Units (MFMU) Network Antenatal Late Preterm Steroids trial 24 was a double-blind, placebo-controlled, randomized clinical trial designed to evaluate the use of antenatal betamethasone for pregnant women at high risk of delivery in the late preterm period. We now would assess the mother’s blood sugar. Chan ISF, Zhang ZX. J Reprod Med 1999;44:257–64. Australas J Ultrasound Med.

It is not intended to substitute for the independent professional judgment of the treating clinician. Lancet 2008;372: 2143–51. A statewide project to promote optimal use of antenatal corticosteroids (ANCS). 713: Antenatal Corticosteroid Therapy for Fetal Maturation“ from the American College of Obstetricians and Gynecologists, there is an error in the abstract. One study reported qualitative focus group data describing conditions that enable delivery of antenatal corticosteroids with high reliability at hospitals that participated in the Ohio Perinatal Quality Collaborative antenatal corticosteroid project 52.

Therefore, corticosteroids should not be administered unless there is substantial clinical concern for imminent preterm birth. However, numerous studies have shown no evidence of long-term harm (and in fact showed improved survival and neurodevelopmental outcomes with long-term pulmonary and other benefits), particularly as it relates to a single course of corticosteroids administered at less than 34 0/7 weeks of gestation 48 12. Committee Opinion No. Epub 2005 Mar 17. [, Guinn DA, Atkinson MW, Sullivan L, Lee M, MacGregor S, Parilla BV, et al. Both lack mineralocorticoid activity and have relatively weak immunosuppressive activity with short-term use.

The March of Dimes Big 5 State Perinatal Collaborative (California, Florida, Illinois, New York, Texas) has developed tools to improve timely administration of antenatal corticosteroids. Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth.

If so we can give a corticosteroid to accelerate fetal lung development.

Implementation of preterm labor assessment toolkits, standardized order sets for women at risk of early delivery, timely availability of medication in settings where pregnant women are cared for, maternal transfer protocols that indicate corticosteroids should be given before transport, and appropriate documentation of first course and rescue course antenatal corticosteroids in inpatient and outpatient health records, have been among the proposed strategies to improve appropriate and timely antenatal corticosteroid use. A collaborative of 54 hospitals from across the Big 5 States has been convened to pilot the new resources to standardize the identification of eligible patients and to improve the appropriate timing of corticosteroid therapy. A Cochrane meta-analysis reinforces the beneficial effect of this therapy regardless of membrane status and concludes that a single course of antenatal corticosteroids should be considered routine for all preterm deliveries 11 12.

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