Document Detail


Antenatal corticosteroid therapy to prevent respiratory distress syndrome.
MedLine Citation:
PMID:  7844686     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The recent National Institutes of Health Consensus Development Conference on ANS was strongly supportive of the use of ANS, even for 24 hours but, if possible, for 48 hours, in all fetuses between 24 and 34 weeks of gestation and at risk of preterm delivery regardless of race, gender, or the availability of surfactant replacement. For preterm rupture of membranes at less than 30 to 32 weeks, the use of ANS was also recommended in the absence of amnionitis, and patients eligible for tocolytic therapy were also deemed eligible for ANS. Thus the currently available literature indicates that pediatricians should encourage obstetricians to provide ANS in high-risk pregnancies, as outlined in the proposed National Institutes of Health guidelines. Even if a full 48-hour course of ANS cannot be achieved, ANS given less than 24 hours before delivery is associated with a decreased incidence of intraventricular hemorrhage and periventricular leukomalacia. In addition, we propose that investigators, reviewers, and editors ensure uniformly high maternal ANS exposure, consistent with the realities of clinical practice, when designing, evaluating, and publishing clinical trials with outcomes (e.g., RDS, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, and death) that can be significantly affected by ANS. Otherwise, studies will continue to be performed on infants who, as fetuses, were deprived of treatment that may have prevented or ameliorated the disorder being assessed. Studies with an infrequent use of ANS may not be applicable or generalizable to an era when the use of ANS is an essential part of perinatal practice. Future trials should document both ANS use and the reasons for failure to achieve an acceptable level of such treatment.
Authors:
C A Ryan; N N Finer
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  126     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-03-08     Completed Date:  1995-03-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  317-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University College Cork, Cork Regional Hospital, Ireland.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use*
Controlled Clinical Trials as Topic
Female
Humans
Infant, Newborn
Pregnancy
Prenatal Care*
Respiratory Distress Syndrome, Newborn / prevention & control*
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones

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