Antenatal corticosteroids for fetal lung maturation in threatened preterm delivery: indications and administration

Archives of Gynecology and Obstetrics, 05/03/2012

The evidence to date is clearly against the routine administration of multiple antenatal steroid courses. In special clinical situations, a second course of betamethasone (“rescue course”) may be justifiable. Tocolysis during administration of steroids is not routinely indicated in the absence of contractions, cervical shortening or rupture of membranes.

Methods

  • The published literature (PubMed search), as well as the recommendations of other national societies, has been searched and taken into consideration for these recommendations.

Results

  • The standard regimen of antenatal corticosteroids involves a single course of 2 × 12 mg betamethasone administered intramuscularly within 24 h.
  • The administration of corticosteroids usually is performed between 24 and 34 weeks gestation.
  • However, under particular circumstances it may be beneficial even at 23 weeks and at 35–36 weeks of gestation.

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