Antenatal steroids for term elective caesarean section

The responsible use of oxygen should also be promoted at all levels. Adequate monitoring is essential, especially in the premature infant <32 weeks gestation and <1 500g birth weight, as these infants are at an increased risk for retinopathy of prematurity (ROP), a leading cause of blindness in children. The second Benefits of Oxygen Saturation Targeting trial (BOOST II) recently reported that lower saturations of 85 - 89%, which reduce the risk of ROP, had a significantly higher rate of death than saturations of 91 - 95%. 9

Treatment with antenatal corticosteroids does not increase the risk of chorioamnionitis ( RR , 95% CI to ; participants = 5546; studies = 15; moderate-quality evidence) or endometritis ( RR , 95% CI to ; participants = 4030; studies = 10; Tau² = , I² = 28%; moderate-quality). No increased risk in maternal death was observed. However, the data on maternal death is based on data from a single trial with two deaths; four other trials reporting maternal death had zero events (participants = 3392; studies = 5; moderate-quality).

Financial Disclosure: OB/GYN Clinical Alert’s editor, Jeffrey T. Jensen , MD, MPH, reports that he is a consultant for and receives grant/ research support from Bayer, Abbvie, ContraMed, and Merck; he receives grant/research support from Medicines 360, Agile, and Teva; and he is a consultant for MicroChips and Evofem. Peer reviewer Catherine Leclair , MD, nurse planners Marci Messerle Forbes, RN, FNP, and Andrea O’Donnell , FNP; AHC Media editorial group manager Terrey L. Hatcher ; executive editor Leslie Coplin ; and editor Journey Roberts report no financial relationships relevant to this field of study.

In a multicentre RCT with 651 infants, Kendig et al [51] showed that there was no clinically significant difference in outcome between immediate administration of prophylactic surfactant and administration at 10 min after birth after a brief period of stabilization (evidence level 1b). However, giving the surfactant as soon as possible once stabilization has occurred seems to be important. The open study of infants at high risk of or with respiratory insufficiency – the role of surfactant (OSIRIS) [52] demonstrated that the combined incidence of death or BPD was reduced by about 11% when surfactant was given at a mean postnatal age of 2 h rather than 3 h (RR=, 95% CI to , evidence level 1b), showing that even fairly short delays in therapy worsen outcomes (evidence level 1b).

Antenatal steroids for term elective caesarean section

antenatal steroids for term elective caesarean section

In a multicentre RCT with 651 infants, Kendig et al [51] showed that there was no clinically significant difference in outcome between immediate administration of prophylactic surfactant and administration at 10 min after birth after a brief period of stabilization (evidence level 1b). However, giving the surfactant as soon as possible once stabilization has occurred seems to be important. The open study of infants at high risk of or with respiratory insufficiency – the role of surfactant (OSIRIS) [52] demonstrated that the combined incidence of death or BPD was reduced by about 11% when surfactant was given at a mean postnatal age of 2 h rather than 3 h (RR=, 95% CI to , evidence level 1b), showing that even fairly short delays in therapy worsen outcomes (evidence level 1b).

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