Is dexamethasone a good idea when we talk about caesarean delivery?

Abstract

Respiratory distress syndrome is one of the most frequently researched and always of immediate interest topics, re­pre­sen­ting one of the main causes of morbidity and mortality in the neonatal population. Therefore, the antenatal ad­mi­nis­tration of corticosteroids in preterm births (between the 24th week and the 34th week of gestational age) is one of the most important antenatal therapies available, with a positive influence on the long-term neonatal prognosis. The effects on both the interstitium and other organs re­duce the risk of respiratory distress syndrome, necrotizing enterocolitis and intracranial hemorrhage. Scientific data about corticosteroid use in women at risk for preterm birth under 34 weeks of gestation and the benefits on the new­born adaptation to the extrauterine life, especially when it comes to caesarean delivery, are abundant. Of course, the benefit of corticoprophylaxis versus the possible long-term results on neurodevelopment, especially in school age, in this category of newborns should be considered. Among early-terms and full-term newborns, delivered by caesarean section, the pathophysiology of respiratory distress is closely related to the absorption of alveolar fluid and to the con­cen­tration of catecholamines in the fetal blood, and if there is no labor, these latter ones are affected. In this article, we present the observations obtained in a study conducted on 81 newborns from pregnancies with ages between 36 0/7 and 37 0/7 weeks, who received dexamethasone less than seven days before birth, conducted within the Obstetrics-Gynecology and Neonatology Clinic of the “Elias” University Emergency Hospital, Bucharest. We compared the results with data published in the field research, having as purpose to elucidate the controversies of antenatal corticosteroid therapy for various populations and, possibly, to establish individualized therapies.