Retrospective analysis on the efficacy of corticosteroid prophylaxis prior to elective caesarean section to reduce neonatal respiratory complications at term of pregnancy: review of literature.
ABSTRACT Our purpose was to conduct a systematic review of the literature to determine whether synthetic pharmaceutical glucocorticoids (betamethasone and dexamethasone) are safe as well as effective in reducing neonatal respiratory morbidity at term of pregnancy prior to elective caesarean section. The overall incidence of respiratory disorders is estimated at 2.8 %, and the main risk factors are gestational age and mode of delivery. Newborns delivered by elective caesarean section (CS after 37 weeks) are more susceptible to serious respiratory complications than babies born by vaginal delivery. Neonatal respiratory morbidity at term of pregnancy is low but not negligible. Further, it is increasing due to a drastic decline in trial of labour in those pregnant women who underwent a caesarean section in the past. Because prophylaxis is inexpensive, easy to administer, and safe, other studies should be conducted to confirm its effectiveness.
We conducted a systematic review of literature since 1965 on the discovery of action mechanisms, pharmaceutical development, proper dosage, and potential side effects of corticosteroids on the mother and offspring to extrapolate their efficacy as no clinical trial has directly demonstrated it.
We extrapolated no negative effects on mother and foetus behaviour.
Human studies suggest that corticosteroid administration may become a proper clinical indication prior to caesarean section in the reduction of neonatal respiratory problems.
Steroids 09/1966; 8(2):179-93. · 2.72 Impact Factor
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ABSTRACT: The frequency of respiratory distress syndrome (RDS) was assessed according to indications for delivery and the presence of antecedent labor among 236 newborns delivered by cesarean section. The presence of labor preceding cesarean section did not reduce the risk of RDS significantly, although a trend, not statistically significant, was noted in this direction. Of the delivery indications evaluated, only abruptio placentae appeared to be associated with an increased risk of RDS. However, prematurity was shown to be a possible confounding variable in this regard. These data suggest that the risk of RDS associated with cesarean section is related to the mode of delivery per se and not necessarily to any of the associated factors evaluated in this study.Obstetrics and Gynecology 02/1981; 57(1):30-2. · 4.37 Impact Factor
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ABSTRACT: Most laboratory tests for fetal lung maturity (FLM) are optimized to exclude false-negative predictions of absence of respiratory distress syndrome (RDS), with a reciprocal low predictive value for maturity. The authors employed FLM Surfactant/Albumin Ratio (FLM S/A) test results to construct a predictive model for FLM that included the obstetric estimates of gestational age. The charts of 388 newborns were abstracted and reviewed. The clinical outcome was the gold standard of the multivariate logistic analysis. Both the obstetric estimates of gestational age and the test result were significant predictors of the clinical outcome (P values of < .0002 and .001, respectively). The prediction rule for RDS as a function of both of these variables allows for adjustment of the test cutoffs, so that there is a consistent probability of RDS at the cutoff FLM S/A result for different gestational ages. Fetal lung maturity probability reporting may facilitate clinical decision-making.American Journal of Clinical Pathology 12/1994; 102(6):788-93. · 3.01 Impact Factor