Antenatal Corticosteroid Therapy for Fetal Maturation

摘要

A single course of corticosteroids is recommended for all pregnant women between 24 and 34 weeks of gestation who are at risk of preterm delivery within 7 days. A single course of antenatal corticosteroids should be administered to women with premature rupture of membranes (PROM) before 32 weeks of gestation to reduce the risks of respiratory distress syndrome, perinatal mortality, and other morbidities. The efficacy of corticosteroid use at 32-33 completed weeks of gestation for preterm PROM is unclear based on available evidence, but treatment may be beneficial, particularly if pulmonary immaturity is documented. No data exist on the efficacy of corticosteroid use before viability, and such use is not recommended at this time. Because of insufficient scientific evidence, repeat corticosteroid courses, including so-called "rescue therapy," should not be used routinely but should be reserved for women enrolled in clinical trials.