OBJECTIVE: To determine the utilisation of antenatal corticosteroid administration in women presenting at risk of preterm birth (PTB) in a centre where tocolytics are not prescribed. DESIGN: A prospective cohort study. SETTING: Tertiary referral centre, Dublin, Ireland. POPULATION: Four hundred and fourteen consecutive women presenting at risk of PTB. METHODS: Clinical details were collated prospectively on all booked patients who presented at risk of PTB (i.e. at <34 weeks of gestation) during 2008. MAIN OUTCOME MEASURE: Rate of administration of antenatal corticosteroids in PTB. RESULTS: Of 8985 deliveries, 414 women (5%) presented at <34 weeks of gestation with a clinical potential for PTB, of whom 277 (67%) received antenatal corticosteroids. Amongst women delivering at <34 weeks of gestation, 93% (80/86) received any corticosteroids and 76% (65/86) received a complete course. The ratio of women given a complete course of corticosteroids to the number who actually delivered before 34 weeks of gestation was 4:1 overall. Analysis by indication for PTB revealed this ratio to be 15:1 in suspected preterm labour (PTL), 8:1 in antepartum haemorrhage (APH), and 2:1 in both preterm prelabour rupture of membranes (PPROM) and medically indicated PTB (MIPTB). Seven of ten multiparae (70%) who delivered prematurely during the study period following PTL had a history of previous PTL before 34 weeks of gestation. CONCLUSION: The ratio of maternal antenatal corticosteroid administration for potential versus actual PTB at <34 weeks of gestation was high in categories such as PTL and substantial APH, whereas selection in PPROM and MIPTB approached 100%. There should be a low threshold for single course therapy for women with prior PTL before 34 weeks of gestation.
OBJECTIVE: To determine the utilisation of antenatal corticosteroid administration in women presenting at risk of preterm birth (PTB) in a centre where tocolytics are not prescribed. DESIGN: A prospective cohort study. SETTING: Tertiary referral centre, Dublin, Ireland. POPULATION: Four hundred and fourteen consecutive women presenting at risk of PTB. METHODS: Clinical details were collated prospectively on all booked patients who presented at risk of PTB (i.e. at <34 weeks of gestation) during 2008. MAIN OUTCOME MEASURE: Rate of administration of antenatal corticosteroids in PTB. RESULTS: Of 8985 deliveries, 414 women (5%) presented at <34 weeks of gestation with a clinical potential for PTB, of whom 277 (67%) received antenatal corticosteroids. Amongst women delivering at <34 weeks of gestation, 93% (80/86) received any corticosteroids and 76% (65/86) received a complete course. The ratio of women given a complete course of corticosteroids to the number who actually delivered before 34 weeks of gestation was 4:1 overall. Analysis by indication for PTB revealed this ratio to be 15:1 in suspected preterm labour (PTL), 8:1 in antepartum haemorrhage (APH), and 2:1 in both preterm prelabour rupture of membranes (PPROM) and medically indicated PTB (MIPTB). Seven of ten multiparae (70%) who delivered prematurely during the study period following PTL had a history of previous PTL before 34 weeks of gestation. CONCLUSION: The ratio of maternal antenatal corticosteroid administration for potential versus actual PTB at <34 weeks of gestation was high in categories such as PTL and substantial APH, whereas selection in PPROM and MIPTB approached 100%. There should be a low threshold for single course therapy for women with prior PTL before 34 weeks of gestation.
Authors: Montse Palacio; Elisenda Bonet-Carne; Teresa Cobo; Alvaro Perez-Moreno; Joan Sabrià; Jute Richter; Marian Kacerovsky; Bo Jacobsson; Raúl A García-Posada; Fernando Bugatto; Ramon Santisteve; Àngels Vives; Mauro Parra-Cordero; Edgar Hernandez-Andrade; José Luis Bartha; Pilar Carretero-Lucena; Kai Lit Tan; Rogelio Cruz-Martínez; Minke Burke; Suseela Vavilala; Igor Iruretagoyena; Juan Luis Delgado; Mauro Schenone; Josep Vilanova; Francesc Botet; George S H Yeo; Jon Hyett; Jan Deprest; Roberto Romero; Eduard Gratacos Journal: Am J Obstet Gynecol Date: 2017-03-23 Impact factor: 8.661
Authors: Matthew A Rysavy; Edward F Bell; Jay D Iams; Waldemar A Carlo; Lei Li; Brian M Mercer; Susan R Hintz; Barbara J Stoll; Betty R Vohr; Seetha Shankaran; Michele C Walsh; Jane E Brumbaugh; Tarah T Colaizy; Abhik Das; Rosemary D Higgins Journal: J Pediatr Date: 2019-02-06 Impact factor: 4.406
Authors: Dane A De Silva; Sarka Lisonkova; Peter von Dadelszen; Anne R Synnes; Laura A Magee Journal: BMC Pregnancy Childbirth Date: 2017-06-29 Impact factor: 3.007