Maternal, fetal, and intra-amniotic hormonal and biologic changes resulting from a single dose of hydrocortisone injected in the intra-amniotic compartment

Abstract

A single intra-amniotic injection of 500 mg. of hydrocortisone sodium succinate was done 48 hours before elective cesarean section in nine patients in week 39 of gestation. Following that single injection, estriol values fell in all three compartments. Cortisol was rapidly increased in the maternal compartment but returned to normal levels at the time of cesarean section in maternal and umbilical vein cord plasma while remaining elevated in the amniotic compartment. Progesterone was increased in the fetal and amniotic compartments but remained essentially unchanged in the maternal compartment. The foam test was constantly improved in the direction of an intermediary or positive test and the quantitative lecithin-sphingomyelin values were increased by almost twofold. In our series, none of our babies developed a respiratory distress syndrome nor had any difficulty with the first breath or the Apgar score. We did not deliver any low-birth-weight infants and the creatinine values were even improved by our injection.