Guideline for the use of antenatal corticosteroids for fetal maturation

Xavier Miracle 1 , Gian Carlo Di Renzo 2 , Ann Stark 3 , Avroy Fanaroff 4 , Xavier Carbonell-Estrany 5 , and Erich Saling (Coordinators of WAPM Prematurity working group) 6
  • 1 Neonatology Service, Hospital Clinic, Institut Clinic de Ginecologia, Obstetricia I Neonatologia, Universitat de Barcelona, Barcelona, Spain
  • 2 Department of Obstetrics and Gynecology and Center for Perinatal and Reproductive Medicine, University of Perurgia, Italy
  • 3 Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
  • 4 Rainbow Babies and Children's Hospital, Cleveland, Ohio and Case Western Reserve University School of Medicine, USA
  • 5 Neonatology Service, Hospital Clinic, Institut Clinic de Ginecologia, Obstetricia I Neonatologia, Universitat de Barcelona, Barcelona, Spain
  • 6 Institute of Perinatal Medicine, Berlin, Neukoelln

Abstract

The aim is to present a document, which is based on current evidence and serves as a guideline for use in clinical practice. The following questions are addressed:

• Is the use of antenatal corticosteroids (ACS) an effective therapy?

• Who are the candidates for antenatal corticosteroid therapy?

• Is there benefit after 34 weeks' gestation?

• When is the optimal time to treat?

• Which are the optimal steroids; what is the ideal dose and route of administration?

• Are there any contraindications to the administration of ACS?

• Are antenatal corticosteroids indicated in women with premature rupture of membranes (PROM)?

• Is the use of ACS recommended in pregnancies complicated by maternal diabetes mellitus?

• Should the treatment with corticosteroids be repeated?

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