CONTROLLED CLINICAL TRIAL
JOURNAL ARTICLE
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Role of Corticosteroids in Reducing Respiratory Morbidity in Neonates Delivered by Elective Cesarean Section before 39 Weeks.

OBJECTIVE: To determine the effect of dexamethasone administration to women between 37 to 39 weeks of gestation on neonatal outcome in terms of respiratory morbidity and the need for NICU admission.

STUDY DESIGN: An experimental study.

PLACE AND DURATION OF STUDY: Department of Obstetrics and Department of Neonatology, Military Hospital, Rawalpindi, Pakistan, from February to July 2017.

METHODOLOGY: Women with singleton pregnancies, undergoing elective cesarean section between 37-39 weeks. Neonates were evaluated for any respiratory morbidity and need for NICU admission as well as need of mechanical ventilation, length of hospital stay and final outcome.

RESULTS: Out of 535 patients, 240 (44.8%) patients received steroid cover before their elective cesarean section (group 1). Two hundred and ninety-five (55.2%) patients who did not receive steroid cover, were allocated group 2. Mean age of mothers in group 1 was 29.20 +4.50 years and in group 2, it was 29.34 +4.50 years. The mean gestational ages were 37.56 +0.66 weeks and 38.11 +0.79 weeks in groups 1 and 2, respectively. In group 2, 14 (4.74%) newborns developed transient tachypnea of newborn (TTN), which was higher than the newborns in group 1 (04 (1.66%), p = 0.049). Also the number of neonates being admitted to NICU was greater in group 2 than in group 1 [23 (7.79%) vs. 06 (2.5%) respectively, p = 0.007].However, there was no statistically significant difference between the two groups with regard to final outcome, requirement for mechanical ventilation, length of hospital stay and APGAR scores at one and five minutes.

CONCLUSION: Steroid cover significantly reduced the risk of respiratory morbidity in babies delivered by elective cesarean section between 37-39 weeks.

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