Effect of Prophylactic Corticosteroid Therapy on Respiratory Morbidity in Infants Borne at Term by Elective Cesarean Section at Omdurman Maternity Hospital

Ismail, Khairy S; Umbeli, T; Mahgoub, Abd Allah; Abdulilah, Kuna; Kholoud, Abdelhalim Mirghani Abdalla; Mohamed, Osman; Elkheir, Hassan A

doi:10.4172/2327-4972.1000215

Cited by 4 publications

(8 citation statements)

References 16 publications

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“…After the duplicates were removed, 176 records were screened for inclusion based on their titles and abstracts. The full texts of the remaining 19 articles were reviewed, and nine articles that fulfilled our predetermined criteria were included in our systematic review and meta-analysis [16][17][18][19][20][21][22][23][24]. The flow chart for study selection according to PRISMA guidelines is shown in Figure 1.…”

Section: Selection and Characteristics Of The Included Studiesmentioning

confidence: 99%

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The Use of Antenatal Dexamethasone in Late Preterm and Term Pregnancies to Improve Neonatal Morbidity and Mortality: A Systematic Review and Meta-Analysis

Samouilidis¹,

Beltsios²,

Mavrovounis³

et al. 2022

Cureus

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There are no acceptable worldwide recommendations regarding the use of dexamethasone in late-preterm newborns delivered either vaginally or via cesarean section and term gestation that are performed via cesarean section. The present study aims to compare the effectiveness of antenatal intramuscular dexamethasone versus placebo/no-treatment in reducing neonatal respiratory complications in high-risk for imminent preterm birth in late preterm pregnancies and term pregnancies undergoing elective cesarean section. The PubMed, Scopus, and Cochrane Library databases were searched to assess the effectiveness of dexamethasone during late preterm and term gestation. The last literature search was performed on March 20th, 2022. Randomized controlled trials compared antenatal dexamethasone administration with placebo or no treatment. The outcomes of interest were: the incidence of Respiratory Distress Syndrome; Transient Tachypnea of the Newborn, Neonatal Intensive Care Unit admissions; and the need for ventilatory support or mechanical ventilation.A standardized data form and three independent investigators performed the data extraction. Ten RCTs fulfilled our inclusion criteria. No statistically significant difference was found regarding all of the outcomes in the 34th-36th gestational week group. In the >37th gestational week group, a statistically significant difference was found regarding the incidence of RDS [RR (95% CI); p-value: 0.56 (0.36, 0.87); 0.01], TTN [RR (95% CI); p-value: 0.54 (0.42, 0.71); <0.00001], need for ventilatory support [RR (95% CI); p-value: 0.71 (0.52, 0.96); 0.03] and need for mechanical ventilation [RR (95% CI); p-value: 0.56 (0.33, 0.95); 0.03]. To conclude, the antenatal administration of dexamethasone can be considered to prevent neonatal complications and reduce perinatal morbidity in term pregnancies.

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Section: Selection and Characteristics Of The Included Studiesmentioning

confidence: 99%

“…Ontela -2018 [19], Attawattanakul -2015 [18], Nabhan -2014 [23], Elbohoty -2020 [21], Afzal -2019 [16], Sadiq -2019 [22], Ismail -2017 [24], Nooh -2017 [20], Ahmed -2015 [17].…”

Section: Figure 4: Bias Assessmentmentioning

confidence: 99%

The Use of Antenatal Dexamethasone in Late Preterm and Term Pregnancies to Improve Neonatal Morbidity and Mortality: A Systematic Review and Meta-Analysis

Samouilidis¹,

Beltsios²,

Mavrovounis³

et al. 2022

Cureus

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“…It constitutes about 30-40% of births, of which around half are elective births. 1 Caesarean section is a major operation that increases both mother and baby's short-term and long-term adverse effects. 2 Caesarean section rate increase is a global phenomenon.…”

Section: Introductionmentioning

confidence: 99%

“…4 According to national sentinel caesarean section audits, in United Kingdom rate of abdominal births is 67% in women with previous caesarean as compared to 34% in primigravidas. 5 Infants born after caesarean delivery are more likely than in vaginally born infants to have respiratory morbidity, and this risk increases further, with potentially severe implications for the subset of children delivered after elective caesarean section 1 . Neonatal respiratory distress syndrome (RDS) is a condition of pulmonary insufficiency that begins at or shortly after delivery and increases in severity over two days of life 6 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Antenatal Corticosteroid Injection in the Prevention of Neonatal Respiratory Distress Syndrome after C-Section

Wali¹,

Gohar²,

Waseem³

et al. 2021

PJMHS

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Aim: To determine the efficacy of antenatal corticosteroid in the prevention of respiratory distress syndrome of the neonates in women undergoing elective cesarean section at term pregnancy. Study design: Descriptive case series Place and duration of study: Department of Obstetrics and Gynecology, Lady Reading Hospital, Peshawar from 6th December 2018 to 6th May 2019. Methodology: One hundred and seventy five women were enrolled. The women after taking complete history with obstetrical examination and antenatal corticosteroid administration i.e. 12 mg dexamethasone IM (two doses 12 hours apart) were observed. The caesarean section was performed by experienced obstetrician having minimum of five years of experience after 24 hours and within seven days of the second dose of dexamethasone. All the neonates were carefully examined in NICU for the detection of respiratory distress syndrome. All these observations were done under supervision of an expert pediatrician having minimum of five years of experience. Results: The mean age was 28±11.34 years. Thirty five percent patients had POG range 37+ weeks while 65% patients had POG range 38+ weeks. Mean POG was 37±1.12 weeks. More over antenatal corticosteroid was effective in 97% patients and was not effective in 3% patients. Conclusion: The antenatal corticosteroid was 97% effective in the prevention of respiratory distress syndrome of the neonates, in women undergoing ELSC at term after elective caesarean section for term pregnancy. Keywords: Efficacy, Antenatal corticosteroid, Respiratory distress syndrome, Neonates, Elective C- section,

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“…Neonatal respiratory complications like respiratory distress syndrome (RDS) and transient tachypnea of newborn (TTN) are more common in infants delivered via LSCS as compared to those delivered vaginally. Studies have shown that about 50 % of neonates with RDS were due to the iatrogenic 5,6 early term caesarean section. Apart from mode of delivery, the gestational age at the time of delivery also affects 5 the neonatal respiratory outcomes.…”

mentioning

confidence: 99%

Effects of Prophylactic Maternal Dexamethasone Administration on the Neonatal Respiratory Outcomes at Term After Elective Caesarean Section: Randomized Controlled Trial

2019

KMUJ

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To assess the effects of prophylactic antenatal dexamethasone administration in reducing the neonatal respiratory morbidity at term after elective lower segment caesarean section (LSCS). METHODS: This open label randomized-controlled trial was conducted in Department of Obstetrics and Gynaecology, Kahuta Research Laboratories (KRL) Hospital, Islamabad from September 2017 to February 2018. Patients with singleton pregnancy and non-anomalous fetus between gestational age of 0 6 RESULTS: A total of 304 women were randomized and equally assigned to interventional and control group. In group-A, 2 neonates developed RDS as compared to one neonate in group-B (p=0.391). Mean age of patients in group A and B was 30.48±4.18 years and 29.38±4.57 years respectively. Fiveminutes Apgar score was 8.91±0.290 in group A & 8.87±0.393 in group B (p=0.320). TTN developed in four neonates in group-A while one neonate in group-B (p=0.176). Eighteen (11.8%) cases in group A & 12(7.9%) cases in group B were admitted in NICU (p=0.249). CONCLUSION: Prophylactic dexamethasone administration in term LSCS after 37 weeks of gestational age has no signicant effects on reducing the incidence of RDS, TTN and neonatal admission to NICU.

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Effect of Prophylactic Corticosteroid Therapy on Respiratory Morbidity in Infants Borne at Term by Elective Cesarean Section at Omdurman Maternity Hospital

Cited by 4 publications

References 16 publications

The Use of Antenatal Dexamethasone in Late Preterm and Term Pregnancies to Improve Neonatal Morbidity and Mortality: A Systematic Review and Meta-Analysis

The Use of Antenatal Dexamethasone in Late Preterm and Term Pregnancies to Improve Neonatal Morbidity and Mortality: A Systematic Review and Meta-Analysis

Efficacy of Antenatal Corticosteroid Injection in the Prevention of Neonatal Respiratory Distress Syndrome after C-Section

Effects of Prophylactic Maternal Dexamethasone Administration on the Neonatal Respiratory Outcomes at Term After Elective Caesarean Section: Randomized Controlled Trial

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