Antenatal corticosteroid prescribing: a complete audit cycle

We undertook an audit of the practice of antenatal steroid prescribing. Data were collected over a prospective 12-week period in an initial audit (2002). Deviations from compliance with guidelines published by the Royal College of Obstetricians and Gynaecologists were identified and a report highlighting the audit findings was disseminated to all maternity units in Glasgow. A repeat audit (2004) was performed over a further prospective 12-week period. A total of 111 women in the initial and 188 women in the repeat audits received corticosteroids. Steroid courses per eventual delivery between 24-36 weeks' gestation increased from 0.64 to 1.18. Repeat courses of steroid decreased from 5% to <1%. Potentially effective courses of steroid increased from 24% to 35%. The proportion of potentially effective steroid courses varied according to the indication. Few steroid courses were potentially effective where the indication was pre-term labour. The findings of this audit are generally encouraging but continuing education regarding the appropriate prescription of antenatal corticosteroids is necessary to maintain and possibly improve upon the findings of this audit.