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Utilization of Antenatal Corticosteroids on premature babies of 27-34 weeks of gestational age born at SSRNH during 2003-2004. Dr S. Burahee Tutor: Dr (Miss) Soobadar. Introduction . Introduction.
Dr S. Burahee
Tutor: Dr (Miss) Soobadar
ANS is a corticosteroid treatment given intramuscular to the pregnant mother at risk of premature delivery.
This corticosteroid will cross blood placental barrier and act upon premature lungs of fetus and help enhancing its maturity.
It is a heterogenous mixture of lipids and proteins. Dipamitoyl phosphatidyl choline is the main component of the surfactant.
It spreads in the lung tissue- air interface
preventing alveolar collapse during
expiration, to open easily at next inspiration.
The alveolar wall collapses during expiration and each inspiration will require considerable effort.
This situation rapidly leads to fatigue, decreased respiratory effort, Hypoxia, cynosis, acidosis and eventually death, if not corrected by immediate treatment.
1. Indicated to all women pregnant of 24 to 34 weeks at risk of premature delivery within 7 days followed.
2. The women of 34-36 weeks can also be given ANS in certain critical condition
e.g. elective c.s for these clinical cases in 7 days following the ANC , e.g. gestational Diabetes mellitus, PIH, Placenta praevia
2 doses of Betamethasone 12mg given IM 24 hrs apart.
-4 doses of dexamethasone 6mg given IM 12 hrs apart
-2 doses of 12 mg given IM 12 to 24 hrs apart.
2 doses of Dexamethasone 12mg IM 12 to 24 hrs apart
In Mauritius, in years 70’s after independence day, IMR was very high due to very high neonatal and perinatal rates.
After the integration of MCH (Maternal & Child Health) programme, antenatal service improved at primary health centre ** and became easily accessible to all & hence mortality rates started decreasing.
At Victoria Hospital, in 1999
At SSRN Hospital, in 2001
But the services are very costly & big economic
burden on Government.
ANS therapy decreases the risk of HMD, hence
decrease the need of NICU treatment & hence the
cost of treatment.
To describe the utilization of ANS in pregnancies of 27-34 weeks with high risk of premature deliveries.
Describe the outcome of premature babies in 3 groups according to ANS:
Selected for study=112
Criteria of inclusion:
Babies of gestational age 27-34 weeks born at
SSRNH only including inutero transfer
Criteria of exclusion:
Premature babies with congenital malformation, infant
of diabetic mother, multiple pregnancies
Group suboptimal whose mothers had
Incomplete course of ANS with short interval
between therapy and delivery, i.e. less than 24 hrs.
Group optimal whose mothers had complete
course of ANS at least 24 hrs before delivery
Mild RDS X Ray chest result, need of
O2 less than 30% fiO2, NO need of surfactant
& less tachypnia
Severe RDS X Ray result, severe tachypnia,
need of O2 more than 30% even with respiratory
Support, need of surfactant
Percentage of antenatal corticotherapy
Very rapid delivery of baby; i.e. within 24 hrs of
hospitalization 26/34 (76.4%) delivered rapidly
Incidence of severe RDS (HMD)
No significant difference in duration of stay in NICU (P-value=0.476)
No significant difference among the 3 groups (P value=0.89)
duration of stay among the 3 groups:
No significant difference among the 3 groups
in occurrence of:
1. Patent ductus arteriosus
2. Intra ventricular hemorrhage
3. Broncho pulmonary dysplasia
This result is due to small size of our sample.
No significant difference among the 3
groups in results of mortality
1. Nosocomial infections are the main cause of neonatal mortality
2. Short duration of study
It suggests to do study on long duration and compile more datas.