Clinical Aspects of Lipids & Human Reproduction. Induce ovulation (Clomid) Assess lung maturation (L/S ratio) Accelerate lung development (glucocorticoids). See Bettelheim et al. Fig. 20.7, p. 491, for hormone levels during a cycle.
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Hormone levels, follicle maturation, and development of the endometrium
Clomid has few side effects.1. This is why it was historically prescribed as a first line treatment. 2. One notable side effect: increased incidence of fraternal multiples.
L/Sodds of RDS
> 2.0 1 in 50*
1.5-2.0 1 in 3
< 1.5 3 in 4
*Action level 2.4
From Practical Clinical Biochemistry 6th ed., Gowenlock, p. 867
1. Administer corticosteroids to mom-to-be.
2. These lipids are transferred to the fetus where they increase the rate of lung maturation. Wait for an appropriate time.
3. After waiting (for time,see McEvoy C, et al. Am J Obstet Gynecol 2000 Oct;183(4):895-9), induce labor or do elective Ceasarean.