Effect of Single Course Versus Repeated Single Course of Antenatal Corticosteroid (Dexamethasone) in Preterm Premature Rupture of Membranes on Neonatal Respiratory Outcome "Randomized Control Trials"

Abstract

Background: Premature ROM (PROM) refers to rupture of the fetal membranes prior to the onset of labor irrespective of gestational age. Aim: To compare between effects of single course versus repeated single course of antenatal corticosteroids in PPROM on neonatal outcomes. Materials and Methods:The study included 200 pregnant patients with established diagnosis of PPROM admitted to Ain Shams University Maternity Hospital, 100 of them received single course regimen (group I) and the other 100 received single course regimen (group II). Newborns were assessed for gestational age, evidence of RDS and congenital infections. Results: There was no statistical difference between the 2 groups regarding age distribution, Parity, gestational age at the onset of ROM and gestational age at delivery. There was no statistical difference between the 2 groups regarding, mode of delivery, birth weight or neonatal deaths, neonatal sepsis. The only variables which was significantly affected between the 2 groups was the development of RDS which was less in the repeated single course group (Group II) than the single course group (Group I) with high statistical significance suggesting that repeated single course improves lung maturity. Conclusion: Repeated single course of corticosteroid is preferred over single course since it has better effect by decreasing the incidence of RDS and the duration on mechanical ventilation.