Reasons for failure to administer antenatal corticosteroids in preterm labour

A retrospective review of 101 preterm infants delivered at Johannesburg Hospital was conducted to determine the use of antenatal corticosteroids (ACs). Overall there were 38 opportunities for the use of ACs of which 18 were missed. Of the remaining mothers, 32 presented in advanced labour, 22 presented with obstetric emergencies and 6 were managed as inevitable abortions. There was a significant association between lack of antenatal care and presentation in advanced labour. Therefore, although only 20% of mothers received ACs, there was no opportunity for their use in the majority of patients. The use of a safe and cost-effective measure such as ACs should not be ignored in a country with limited health resources. Better antenatal care as well as increased awareness among obstetricians is required to improve the situation.