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[Antenatal Steroid Therapy in Threatened Premature Birth - State of the Art]
Dimitra Stavropoulou1, Roland Hentschel1
1Neonatologie und pädiatrische Intensivmedizin, Universitätsklinikum Freiburg, Freiburg.
Insights
This review summarizes recommendations for antenatal steroid therapy to induce lung maturation, focusing on special situations like chorioamnionitis and growth restriction. It analyzes benefits and risks of repetitive steroid use, based on the 2015 Cochrane analysis.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Pharmacology
Background:
- Premature birth remains a significant challenge in neonatal care.
- Antenatal steroid therapy is crucial for lung maturation in preterm infants.
- Specific maternal conditions complicate optimal timing and use of this therapy.
Purpose of the Study:
- To review current literature on recommendations for antenatal steroid therapy.
- To focus on its use in pregnancies complicated by chorioamnionitis, intrauterine growth retardation, and preeclampsia.
- To clarify aspects of repetitive antenatal steroid administration and its implications.
Main Methods:
- Literature review of current recommendations.
- Analysis of the 2015 Cochrane review on antenatal steroid therapy.
- Examination of data regarding maternal and neonatal outcomes.
Main Results:
- Guidelines for antenatal steroid therapy in specific high-risk pregnancies are presented.
- Advantages and disadvantages of repetitive steroid courses for mother and child are discussed.
- Data on antenatal steroid therapy in multiple pregnancies are identified as insufficient.
Conclusions:
- Antenatal steroid therapy is vital but requires careful consideration in complicated pregnancies.
- Further research is needed on repetitive steroid administration and its use in multiple gestations.
- Optimizing antenatal steroid therapy protocols can improve neonatal outcomes.
Abstract:
The aim of this work is to provide an overview of the recommendations in the current literature for the induction of lung maturation therapy. In particular, special attention is focused on specific situations, such as chorioamnionitis, intrauterine growth retardation and preeclampsia, which often lead to premature birth. Additionally, some aspects of antenatal steroid therapy, despite its widespread use, still require clarification. Among them is the repetitive administration of steroid therapy. On the basis of the Cochrane analysis of 2015, advantages and disadvantages for children and pregnant women are explained. Furthermore, the data on the use of antenatal steroid therapy in multiple pregnancies remain insufficient.
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