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The effect of thyroxine and corticosteroids upon amniotic fluid fluorescence polarization: a randomized controlled
G Barkai1, B Reichman, A Lusky
1Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.
Journal of Perinatal Medicine
|January 1, 1992
Summary
Intra-amniotic thyroxine and intramuscular dexamethasone showed similar efficacy in improving fetal lung maturity. Thyroxine therapy may be a viable alternative for pregnant individuals with contraindications to steroids.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Pharmacology
Background:
- Fetal lung maturity is crucial for neonatal respiratory outcomes.
- Glucocorticoids are commonly used to enhance fetal lung maturity.
- Alternative therapies are needed for cases with contraindications to steroids.
Purpose of the Study:
- To compare the efficacy of intra-amniotic thyroxine versus intramuscular dexamethasone in promoting fetal lung maturity.
- To evaluate the impact of these therapies on amniotic fluid fluorescence polarization (FP).
Main Methods:
- A randomized prospective clinical trial involving 82 patients.
- Treatment groups: intra-amniotic thyroxine (n=36) and intramuscular dexamethasone (n=46).
- Amniotic fluid FP measured before and one week post-treatment; rate of decrease (dFP/dt) analyzed.
Main Results:
- Both therapies resulted in similar amniotic fluid FP values and rates of decrease (dFP/dt).
- The proportion of immature FP values was comparable between the thyroxine and corticosteroid groups.
- Thyroxine's effect was more pronounced in pregnancies over 33 weeks gestation.
Conclusions:
- Intra-amniotic thyroxine is as effective as glucocorticoids in enhancing fetal lung maturity.
- Thyroxine therapy presents a potentially useful alternative for pregnant individuals with contraindications to steroid administration.