EFFICACY OF PROPHYLACTIC CORTICOSTEROIDS PRIOR TO CESAREAN SECTION TO PREVENT RESPIRATORY COMPLICATION

Abstract

Background: Cesarean section (CS) is a risk factor for the development of neonatal respiratory complications, mostly respiratory distress syndrome (RDS) and transient tachypnea of the new-born, both in term and preterm infants. Infants born at term by elective cesarean delivery are more likely to develop respiratory morbidity than infants born vaginally. Objective: To assess the effect of prophylactic corticosteroid administration before elective cesarean section at term, as compared to usual management without corticosteroids, in reducing neonatal respiratory morbidity and admission to special care with respiratory complications. Patients and methods: This was a prospective study that was conducted on 200 women from the Out-Patient Clinic at Al-Hussein Hospital, Al-Azhar University from September 2018 to November 2019. Randomized controlled trials comparing prophylactic antenatal corticosteroid administration (dexamethasone) with placebo or with no treatment, given before elective cesarean section at term (at or after 37 weeks of gestation). Results: PG represented 60% of 1st group while represented 50% of 2nd group without significant difference between them. There was no significant difference between groups as regard co-morbidity. There was no significant difference between groups regard causes of CS, and the major causes were previous CS and placenta previa. There was no significant difference between groups as regard postpartum hemorrhage or maternal complication in general. APGAR1 was significantly higher among corticosteroid group. Overall respiratory complication was significantly lower among corticosteroid group, respiratory distress (RD), need of neonatal intensive care unit (NICU) and mechanical ventilation and mortality were lower among the same group than control but not significantly. Conclusion: A single course of corticosteroids (four 6mg doses of dexamethasone administered intramuscular every 12 hours) should be considered for women undergoing planned cesarean at 37 or more weeks’ gestation.