Dexamethasone for the prevention of neonatal respiratory morbidity before elective cesarean section at term

Salem, Mohammed N.; Abbas, Ahmed M.; Ashry, Mostafa

doi:10.17077/2154-4751.1321

Cited by 5 publications

(14 citation statements)

References 15 publications

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“…18 On the other side many studies proved that steroids given at term prior surgical delivery were effective in reducing respiratory morbidity, neonatal sepsis and special care units admissions. 8,9,19 A large trial (ASTEC trial) found that the incidence of respiratory distress at term are reduced to the half and 6-fold decrease in the rate of NICU admission in patient given antenatal steroids. 20 Recently, many researchers requested to revisit steroids before scheduled CD based on the facts that steroids are similar to all drugs having both benefits and risks either short term or long-term risks.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 The benefits of steroids before scheduled CD at term are still controversial where some studies reported benefits and reduction in respiratory morbidity; other studies not recommend its use at term or even linked its use to some complications. [7][8][9][10][11][12] This study was conducted to evaluate whether dexamethasone injections at term is beneficial in reducing neonatal incubation admissions or not.…”

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confidence: 99%

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The neonatal outcomes of Dexamethasone administration before scheduled cesarean delivery at term: a randomized clinical trial

Elbohoty

Dawood

Abbas

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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Background: Caesarean delivery (CD) rates in developing countries are rising beyond the recommended rates of World health organization. Objective of this study was to evaluate whether Dexamethasone injections reduce neonatal incubation admissions when given before scheduled caesarean delivery (CD) at term or not.Methods: A double blinded, two armed, randomized clinical trial was conducted at Tanta University hospitals in the period from October 2017 to March 2019. Four hundred pregnant women admitted for scheduled CD with gestational age ≥37 weeks were included. Patients were randomized into study group and control group. The study group was given 3 dexamethasone doses, 8 mg each while control group was given saline injections simultaneously as a placebo drug. The primary outcome was the neonatal incubatory admissions.Results: Demographic data in both groups were comparable. Transient tachypnea of newborn (TTN) was 15.47% in study group versus 20.33% in control group with p=0.227. The respiratory distress (RDS) in study group was 6.63% versus 9.89% in control group with p=0.260. The incubation admissions were nasal oxygen 12.71% versus 15.38%, continuous positive airway pressure ventilation (CPAP) 5.52% versus 8.24% and mechanical ventilation was 3.87% versus 6.59% in the study and control groups respectively.Conclusions: Although Dexamethasone administration before scheduled CD at term reduced both respiratory morbidity and incubation admissions, the differences between study and control groups were not significant.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The neonatal outcomes of Dexamethasone administration before scheduled cesarean delivery at term: a randomized clinical trial

Elbohoty

Dawood

Abbas

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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View full text Add to dashboard Cite

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“…Cesarean delivery is a known risk factor for neonatal respiratory complications, mostly transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS) in infants at or near term. The respiratory morbidities may be severe and even fatal (1) . for the period between 37 weeks to 37 weeks and 6 days to 0.8% for the period between 39 weeks to 39 weeks and 6 days.…”

Section: Introductionmentioning

confidence: 99%

“…No serious side effects have been reported after administration of corticosteroids during pregnancy, but some studies reported a reduction in fetal body movements, fetal breathing movements and heart rate variation after betamethasone administration ( 1 ) .…”

Section: Introductionmentioning

confidence: 99%

Does Corticosteroids Administration after 37 Weeks for Elective Lower Segment Cesarean Section Reduce Neonatal Respiratory Morbidity? a Randomized Controlled Trial.

Elewa

Saad

Soliman

et al. 2020

Benha Medical Journal

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Background: Cesarean delivery is a known risk factor for neonatal respiratory complications, mostly transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS) in infants at or near term. The current study aimed to assess the efficacy of steroids administered before performing term (37-39 weeks), elective caesarean section in reducing neonatal respiratory morbidity and. Methods: This is a randomized controlled study which was done on Benha University Hospital and Benha Teaching Hospital, Egypt. Four hundred cases were divided into two groups. Group A (Steroid Group): included 200 cases who received two intramuscular (IM) doses of 12 mg dexamethasone 12 hours apart, 24 hours before elective CS. Group B (Control Group): included 200 cases who received IM saline as a placebo in the same regimen as the steroid group. Results: There was no statistically significant difference between group A and group B regarding maternal age, BMI, gravidity, mean number of previous C.S. birth weight and gestational age. Mean value of Apgar scores at 1 and 5 minutes was statistically significant higher among group A than group B.TTN was statistically significant lower among group A than group B. Admission to NICU was statistically significant lower among group A than group B. There was statistically significant higher numbers of neonates in group A than in group B regarding neonatal need for CPAP. Conclusion : Prophylactic intramuscular injection of 12 mg dexamethasone 12 hours apart, 24 hours before elective CS at gestational age of 37 to 39 weeks can reduce neonatal respiratory morbidity

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“…Therefore, it is considered that whether there is a way that can effectively prevent the occurrence of lower back pain, or can effectively reduce the degree of pain. In the study of Salem et al ( 5 ), dexamethasone (DXMS) was shown to be effective in reducing adverse anesthesia during cesarean delivery. Thus whether DXMS also reduces back pain following epidural delivery analgesia is considered.…”

Section: Introductionmentioning

confidence: 99%

Local injection of dexamethasone helping to prevent lower back pain after epidural delivery analgesia

Yang

Liu

et al. 2018

Exp Ther Med

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This report aims to retrospectively analyze the clinical effect of local pretreatment with dexamethasone (DXMS) on lower back pain after epidural labor analgesia. Patients with epidural labor analgesia treated in People's Hospital of Rizhao from January 2014 to December 2016 were studied. All 368 cases involved were pregnant primipara with full-term single birth. Parturient received injection of DXMS and lidocaine mixture around the epidural puncture point was the observation group (n=188), and parturient received injection of 0.9% sodium chloride and lidocaine mixture around the epidural puncture point was the control group (n=180). The incidence and degree of lower back pain postoperatively in the two groups were evaluated by pain visual analogue scale method. The incidence of lower back pain at 48 h, 72 h after operation in observation group was significantly lower than that in control group (p<0.05). Among patients undergoing one puncture and more than one puncture, the incidence of postoperative lower back pain in the observation group was significantly lower than that in the control group (59.26%) (p<0.05). Among the parturient with spontaneous delivery, the incidence of postoperative lower back pain in the observation group was significantly lower than that in the control group (p=0.028). Among the cesarean section patients, the incidence of pain in observation group was significantly lower than that in control group (p=0.019). At 48 and 72 h after operation, severe pain in the observation group was significantly less than that in the control group (p<0.05). DXMS local pretreatment can significantly reduce the incidence of postoperative lower back pain and the degree of pain after epidural delivery analgesia. DXMS pretreatment in epidural analgesia deserved to be widely used clinically.

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Dexamethasone for the prevention of neonatal respiratory morbidity before elective cesarean section at term

Abstract: Background: Respiratory distress syndrome (RDS) is the principal cause of early neonatal morbidity and mortality.

Cited by 5 publications

References 15 publications

The neonatal outcomes of Dexamethasone administration before scheduled cesarean delivery at term: a randomized clinical trial

The neonatal outcomes of Dexamethasone administration before scheduled cesarean delivery at term: a randomized clinical trial

Does Corticosteroids Administration after 37 Weeks for Elective Lower Segment Cesarean Section Reduce Neonatal Respiratory Morbidity? a Randomized Controlled Trial.

Local injection of dexamethasone helping to prevent lower back pain after epidural delivery analgesia

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