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Antenatal corticosteroid therapy

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https://www.readbyqxmd.com/read/28068594/prevention-of-spontaneous-preterm-birth-guidelines-for-clinical-practice-from-the-french-college-of-gynaecologists-and-obstetricians-cngof
#1
REVIEW
Loïc Sentilhes, Marie-Victoire Sénat, Pierre-Yves Ancel, Elie Azria, Guillaume Benoist, Julie Blanc, Gilles Brabant, Florence Bretelle, Stéphanie Brun, Muriel Doret, Chantal Ducroux-Schouwey, Anne Evrard, Gilles Kayem, Emeline Maisonneuve, Louis Marcellin, Stéphane Marret, Nicolas Mottet, Sabine Paysant, Didier Riethmuller, Patrick Rozenberg, Thomas Schmitz, Héloïse Torchin, Bruno Langer
In France, 60,000 neonates are born preterm every year (7.4%), half of them after the spontaneous onset of labor. Among preventable risk factors of spontaneous prematurity, only cessation of smoking is associated with decreased prematurity (level of evidence [LE]1). It is therefore recommended (Grade A). Routine screening and treatment of vaginal bacteriosis is not recommended in the general population (Grade A). The only population for which vaginal progesterone is recommended is that comprising asymptomatic women with singleton pregnancies, no history of preterm delivery, and a short cervix at 16-24 weeks of gestation (Grade B)...
December 30, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28029463/-tocolysis-for-preterm-labor-without-premature-preterm-rupture-of-membranes
#2
M Doret, G Kayem
OBJECTIVES: To propose guidelines for clinical practice for tocolysis in preterm labor without premature preterm rupture of the membranes (PPROM). MATERIALS AND METHODS: Bibliographic searches were performed in the Medline and Cochrane databases and gynecologist and obstetricians' international society guidelines. It is important to note that most studies included women in preterm labour with and without PPROM. RESULTS: Compared with placebo, tocolytics are not associated with a reduction in neonatal mortality or morbidity (LE2)...
October 28, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28026890/influence-of-the-interval-between-antenatal-corticosteroid-therapy-and-delivery-on-respiratory-distress-syndrome
#3
Ichiro Yasuhi, Mai Myoga, Sachie Suga, So Sugimi, Yasushi Umezaki, Masashi Fukuda, Hiroshi Yamashita, Nobuko Kusuda
AIM: In spite of the recommendation for rescue antenatal corticosteroids (ACS), the optimal time interval between primary and rescue courses has not been clearly demonstrated. The aim of this study was to determine the effects of the interval between a single ACS course and delivery on the incidence of respiratory distress syndrome (RDS). METHODS: In this retrospective study, we included singleton pregnant women who received a single course of ACS and delivered beyond 48 h after ACS administration between 24 and 33 weeks' gestation...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27836377/-prevention-of-spontaneous-preterm-birth-excluding-preterm-premature-rupture-of-membranes-guidelines-for-clinical-practice%C3%A2-%C3%A2-text-of-the-guidelines-short-text
#4
L Sentilhes, M-V Sénat, P-Y Ancel, E Azria, G Benoist, J Blanc, G Brabant, F Bretelle, S Brun, M Doret, C Ducroux-Schouwey, A Evrard, G Kayem, E Maisonneuve, L Marcellin, S Marret, N Mottet, S Paysant, D Riethmuller, P Rozenberg, T Schmitz, H Torchin, B Langer
OBJECTIVES: To determine the measures to prevent spontaneous preterm birth (excluding preterm premature rupture of membranes)and its consequences. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: In France, premature birth concerns 60,000 neonates every year (7.4 %), half of them are delivered after spontaneous onset of labor...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27776846/-prevention-of-preterm-birth-complications-by-antenatal-corticosteroid-administration
#5
T Schmitz
OBJECTIVE: To evaluate short- and long-term benefits and risks associated with antenatal administration of a single course of corticosteroids and the related strategies: multiple and rescue courses. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Antenatal administration of a single course of corticosteroids before 34 weeks of gestation is associated in the neonatal period with a significant reduction of respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC) and death (LE1), and in possibly childhood with a reduction of cerebral palsy and increased psychomotor development index and intact survival (LE3)...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27661658/committee-opinion-no-677-antenatal-corticosteroid-therapy-for-fetal-maturation
#6
(no author information available yet)
Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes. A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family's decision regarding resuscitation, irrespective of membrane rupture status and regardless of fetal number...
2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27661650/committee-opinion-no-677-summary-antenatal-corticosteroid-therapy-for-fetal-maturation
#7
(no author information available yet)
Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes. A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family's decision regarding resuscitation, irrespective of membrane rupture status and regardless of fetal number...
October 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27545716/preventing-newborn-deaths-due-to-prematurity
#8
REVIEW
Kishwar Azad, Jiji Mathews
Preterm births (PTBs), defined as births before 37 weeks of gestation account for the majority of deaths in the newborn period. Prediction and prevention of PTB is challenging. A history of preterm labour or second trimester losses and accurate measurement of cervical length help to identify women who would benefit from progesterone and cerclage. Fibronectin estimation in the cervicovaginal secretions of a symptomatic woman with an undilated cervix can predict PTB within 10 days of testing. Antibiotics should be given to women with preterm prelabour rupture of membranes but tocolysis has a limited role in the management of preterm labour...
October 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27543098/antenatal-corticosteroid-therapy-for-foetal-maturation-in-women-with-eclampsia-and-severe-pre-eclampsia-in-a-rural-hospital-in-western-tanzania
#9
R Mooij, I H Mwampagatwa, J van Dillen, J Stekelenburg
BACKGROUND: Preterm birth is a major cause of neonatal mortality, especially in low and middle income countries. Antenatal corticosteroid therapy for foetal maturation could have a significant impact and therefore is often referred to as an important strategy to reduce neonatal mortality. A recently conducted large multinational trial showed that antenatal corticosteroids can have adverse effects in low income countries, but this is likely to depend on the specific setting. In our hospital preterm birth is only recognized in patients with severe maternal disease, due to physician-initiated delivery...
2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27512476/antenatal-steroids-for-fetal-lung-maturity-time-to-target-more-frequent-doses-to-fewer-women
#10
REVIEW
Carolyn I Freeman, Natasha L Hezelgrave, Andrew H Shennan
Antenatal corticosteroids for fetal lung maturation have become mainstay treatment in women thought to be at high-risk of premature birth. To ensure treatment efficacy before delivery, the current practice is to administer steroids early to a woman considered at risk; however, neonatal benefit is lost after the seven-day treatment-to-delivery window. Over half of women who deliver before 34 weeks' gestation do not receive antenatal corticosteroids within this timeframe, but many still deliver prematurely; however, clinicians are reluctant to administer repeated courses of steroids due to concerns, among others, of impaired fetal growth...
December 2015: Obstetric Medicine
https://www.readbyqxmd.com/read/27504942/antenatal-corticosteroids-and-respiratory-distress-syndrome-the-first-polish-national-survey
#11
Maria Katarzyna Borszewska-Kornacka, Ewa Gulczyńska, Marzena Kostuch, Piotr Korbal, Paweł Krajewski, And The Polish Study Group
OBJECTIVES: Our retrospective study aimed to evaluate the rate and the appropriate use of antenatal corticosteroid therapy, and their effect on the incidence and treatment of respiratory distress syndrome (RDS) and its complications. MATERIAL AND METHODS: A retrospective analysis of clinical practice in Poland was performed using standard investigating tools: a questionnaire on the frequency of using antennal corticosteroids in the selected centers, as well as neonatal data...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27487405/antenatal-corticosteroid-treatment-factors-other-than-lung-maturation
#12
Kjell Haram, Jan Helge Mortensen, Everett F Magann, John C Morrison
Antenatal corticosteroid therapy improves both fetal lung mechanism and gas exchange due to accelerated morphologic development of type one and two pneumocytes. This therapy also enhances the production of surfactant binding proteins and fetal lung antioxidant enzymes. In women with threatening preterm delivery, a single course is advocated between 24 and 34 weeks' gestation with either betamethasone (two doses of 12 mg 24 hours apart) or dexamethasone (4-doses of 6 mg at 12-h intervals). Such treatment reduces the rate of respiratory distress syndrome, comorbidity and mortality in neonates in the first 48 hours of life...
August 3, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27214190/obstetric-care-consensus-no-4-periviable-birth
#13
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
June 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27214184/obstetric-care-consensus-no-4-summary-periviable-birth
#14
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
June 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27143398/structural-and-transcriptomic-response-to-antenatal-corticosteroids-in-an-erk3-null-mouse-model-of-respiratory%C3%A2-distress
#15
Braden K Pew, R Alan Harris, Elena Sbrana, Milenka Cuevas Guaman, Cynthia Shope, Rui Chen, Sylvain Meloche, Kjersti Aagaard
BACKGROUND: Neonatal respiratory distress syndrome in preterm infants is a leading cause of neonatal death. Pulmonary insufficiency-related infant mortality rates have improved with antenatal glucocorticoid treatment and neonatal surfactant replacement. However, the mechanism of glucocorticoid-promoted fetal lung maturation is not understood fully, despite decades of clinical use. We previously have shown that genetic deletion of Erk3 in mice results in growth restriction, cyanosis, and early neonatal lethality because of pulmonary immaturity and respiratory distress...
September 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27103153/periviable-birth-interim-update
#16
Jeffrey L Ecker, Anjali Kaimal, Brian M Mercer, Sean C Blackwell, Raye Ann O deRegnier, Ruth M Farrell, William A Grobman, Jamie L Resnik, Anthony C Sciscione
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
August 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27102371/the-ongoing-quandary-of-defining-the-standard-of-care-for-neonates
#17
REVIEW
Avroy A Fanaroff, Jonathan M Fanaroff
UNLABELLED: Despite extensive use of the term 'standard of care' (SOC), there is no such medical definition. How are neonatal therapies accepted as SOC with huge centre-to-centre variation? What defines SOC? We will consider paths to acceptance of multiple therapies (antenatal corticosteroids, preventing GBS, others). We conclude single-centre trials drive care, but are not consistently predictive for multicentre trials. Innovation/quality improvement initiatives also alter care, despite strong evidence practice changes take time...
September 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27005705/relation-between-time-interval-from-antenatal-corticosteroids-administration-to-delivery-and-neonatal-outcome-in-twins
#18
Katarzyna Kosinska-Kaczynska, Iwona Szymusik, Paulina Urban, Maria Zachara, Miroslaw Wielgos
AIM: The aim of this study was to evaluate the perinatal outcome in twins, who were administered one complete course of antenatal corticosteroids (ACS) depending on the time interval from corticosteroids to delivery. METHODS: We carried out a retrospective analysis of medical data of women with twins who received a course of ACS and delivered before 34 weeks within or beyond 7 days after ACS were given. Among 652 twin deliveries between 2006 and 2014, 106 met the criteria (50 patients delivered <7 days and 56 ≥ 7 days after ACS administration)...
June 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/26959200/antenatal-corticosteroid-therapy-before-24-weeks-of-gestation-a-systematic-review-and-meta-analysis
#19
REVIEW
Christina K Park, Tetsuya Isayama, Sarah D McDonald
OBJECTIVE: To evaluate the effectiveness of antenatal corticosteroids compared with placebo or no treatment in neonates born before 24 weeks of gestation. DATA SOURCES: We searched MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Central Register of Controlled Trials databases from 1990 to March 13, 2015, and ClinicalTrials.gov. METHODS OF STUDY SELECTION: Studies considered were published randomized or quasirandomized controlled trials and observational studies that compared outcomes between neonates who received or did not receive antenatal corticosteroids born before 24 weeks of gestation...
April 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26875954/antepartum-and-intrapartum-interventions-to-prevent-preterm-birth-and-its-sequelae
#20
REVIEW
T A J Nijman, E O G van Vliet, B Koullali, B W Mol, M A Oudijk
Preterm birth is the main cause of neonatal morbidity and mortality. This review provides an overview of antepartum and intrapartum management of threatened preterm birth. The most effective method to identify women at high risk of delivering within seven days is the combination of cervical length and fetal fibronectin test. Antenatal corticosteroids administered for 48 h improve neonatal outcome. Although tocolysis has been shown to prolong pregnancy, there is no evidence that tocolytic therapy improves neonatal outcomes...
April 2016: Seminars in Fetal & Neonatal Medicine
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