IMR Press / CEOG / Volume 28 / Issue 3 / pii/2001051

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research

The effect of antenatal corticosteroid therapy on pregnancies complicated by premature rupture of membranes

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1 Department of Obstetrics and Gynecology, Jordan
2 Department of Pediatrics Royal Medical Services, Jordan
Clin. Exp. Obstet. Gynecol. 2001, 28(3), 183–186;
Published: 10 September 2001
Abstract

This study was carried out to examine the effect of antenatal corticosteroid therapy on pregnancies complicated by premature rupture of membranes (PROMs). For this purpose, 139 patients with a singleton pregnancy (27-34 weeks of gestation) complicated by PROMs were evaluated prospectively during the period January 1997 to February 1999 at two Jordanian military hospitals (Prince Rhashed and Prince Zaid). Patients were allocated into two groups; Group I included 72 patients treated with dexameth­sone (24 mg divided into 4 doses 12 hours apart), and Group 2 which included 67 patients who received no treatment (control group). All women were examined clinically and the diagnosis of PROMs was demonstrated using vaginal speculum, nitrazine paper examination and ultrasonography. All neonates were evaluated clinically, radiologically, and by laboratory investigations. Pearson’s Chisquare and Fisher’s exact tests were used to assess the significance of differences between the two study groups. Respiratory distress syndrome (RDS), necrotizing enterocolitis (NEC), intraventricular haemorrhage (IVH), and days of hospital stay were significantly reduced in premature infants of the corticosteroid treated women compared with the controls (p < 0.04, p < 0.04, p < 0.04, and p < 0.05, respectively). The perinatal mortality was significantly decreased among the corticosteroid treated group in the gestational subgroups 31-32 and 33-34 weeks (p < 0.04), and in all birth weight sub groups (p < 0.03). RDS was statistically a significant factor which resulted in increased perinatal mortality in the control group (p = 0.02). Regarding the occurrence of postpartum endometritis there was a statistically significant increase among the corticosteroid treated group compared with the controls (p < 0.04). Conclusion: Antenatal corticosteroid therapy in pregnancies complicated by PROMs has a positive influencing effect on prema­ture infants between 31 and 34 weeks of gestation, decreasing significantly the perinatal morbidity and mortality. It should be used with particular relevance to the developing world where surfactant is not available or where neonatal intensive care units are lacking.

Keywords
Premature rupture of membranes
Premature delivery
Corticosteroids
Perinatal morbidity and mortality
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