At 40 weeks, the organs are usually fully developed. If a baby is born too early, the lungs may not be fully developed, and they may not function properly.
Immature Lungs – Most babies have mature lungs by 36 weeks of gestation.
Antenatal betamethasone is primarily used to speed up lung development in preterm fetuses. It stimulates the synthesis and release of surfactant (2), which lubricates the lungs, allowing the air sacs to slide against one another without sticking when the infant breathes.
A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation, and may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days 1 11 13.
The most common steroid, betamethasone (Celestone), is given in two doses, 12 milligrams (mg) each, 12 or 24 hours apart. The medications are most effective from 2 to 7 days after the first dose.
The elevated level of progesterone suppresses the production of oxytocin, keeping the mother from going into labor. Maybe this is also why some women are a bit irritable during pregnancy. It may also explain why some women have what is called, premenstrual irritability.
Do not stop using the medicine even if you feel better unless the doctor tells you so. Using of the medicine may cause few common side effects such as mood changes, depression, stomach upset, and injection site reactions. You may also experience pain, redness, and swelling at the site of injection.
Steroid injections given to pregnant women before premature birth may increase the child's risk of later behavioural difficulties, a study has found. Mothers who are expected to give birth prematurely are often given an infusion of glucocorticoids, which mimic the natural hormone cortisol.
Fetal lung maturity can be estimated pre-natally by examination of the amniotic fluid, usually obtained by transabdominal amniocentesis, for lecithin, lecithin/sphingomyelin (L/S) ratio or 'P' factor (fluorescent polarization measurement for lipids).
Conclusion: Dexamethasone accelerates maturation of fetal lungs, decrease number of neonates with respiratory distress syndrome and improves survival in preterm delivered neonates. Optimal gestational age for use of dexamethasone therapy is 31 to 34 weeks of gestation.
Medication SummaryMaternal steroids to accelerate lung maturity of the fetus are indicated in preterm labor. The most common tocolytic agents used for the treatment of preterm labor are magnesium sulphate (MgSO4), indomethacin, and nifedipine.
Maternal short-term effects after multiple courses of corticosteroids are an increase of infections and a higher incidence of endometritis and chorionamnionitis in patients with premature rupture of membranes.
Antenatal corticosteroid therapy is recommended for women with pre-gestational and gestational diabetes who are at risk of imminent preterm birth. Women who are receiving fetal steroids should have additional insulin according to an agreed protocol and be closely monitored.
[9] The difference between dexamethasone and betamethasone on NST, AFI, and BPP, dexamethasone has no clear effect on NST, AFI, and BPP but betamethasone usually decreases AFI in 63% of cases, short beat to beat in NST in all cases and fetal movement in 80% cases but other parameters have no changes.
Summary: For treatment of women at risk of preterm delivery, dexamethasone is recommended over betamethasone based on its efficacy, safety, wide availability, and low cost.
Dexamethasone relieves inflammation in various parts of the body. It is used specifically to decrease swelling (edema), associated with tumors of the spine and brain, and to treat eye inflammation. To treat or prevent allergic reactions.
Dexamethasone is long-acting and is considered a potent, or strong, steroid. It is 25 times more potent than hydrocortisone. The initial dosage of dexamethasone may vary from 0.75 to 9 mg a day, depending on the condition being treated.
Who should not take DEXAMETHASONE?
- active, untreated tuberculosis.
- inactive tuberculosis.
- herpes simplex infection of the eye.
- a herpes simplex infection.
- an infection due to a fungus.
- intestinal infection caused by the roundworm Strongyloides.
- a condition with low thyroid hormone levels.
- diabetes.
Dexamethasone is a long-acting corticosteroid with a half-life of 36 to 72 hours.
Dexamethasone reduces morbidity and mortality in bacterial meningitis by blunting the inflammatory response secondary to bacterial lysis, which frequently causes detrimental physiologic effects. Dexamethasone should be given prior (20 minutes before) or concurrently with antibiotics.
How long do dexamethasone side effects last? With a half-life of four hours (the amount of time it takes the body to eliminate half a dose), a 20 mg dose is eliminated from the body in about 24 hours. Many of the temporary side effects of dexamethasone, such as mood changes or anxiety, will wear off by that time.
This drug works by dampening down the body's immune system. Coronavirus infection triggers inflammation as the body tries to fight it off.
Dexamethasone 3.3 mg/ml Solution for Injection may be administered by intramuscular, intraarticular or direct intravenous injection, intravenous infusion or soft tissue infiltration.
Commonly reported side-effects after taking steroids are: • Flushing of the mother's face and chest. Some glucose appearing in the mother's urine for a day or two. Some difficulty in getting off to sleep at night for one or two days. Some reduction in the baby's movements for about 24 hours.
Betamethasone may cause side effects.Tell your doctor if any of these symptoms are severe or do not go away:
- burning, itching, irritation, stinging, redness, or dryness of the skin.
- acne.
- unwanted hair growth.
- skin color changes.
- bruising or shiny skin.
- tiny red bumps or rash around the mouth.
If you are having a planned caesarean section before 39 weeks of pregnancy, corticosteroids are recommended to lessen the chance of breathing problems for your baby. If you have diabetes or gestational diabetes, you may need to be in hospital since corticosteroids increase the blood sugar level.
It is known that administration of steroids increases blood sugar levels. Administration of betamethasone is common practice during pregnancy to women at risk for preterm delivery. However, it is unknown the magnitude of the changes in glucose these women have after receiving betamethasone.
When used during pregnancy betamethasone may also temporarily reduce the baby's heart rate and body movements. As a result this medicine should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the developing baby.
Multiple factors can decrease perception of movement, including early gestation, a reduced volume of amniotic fluid, fetal sleep state, obesity, anterior placenta (up to 28 weeks gestation), smoking and nulliparity.
Conclusions: Betamethasone induces a profound, albeit transient, suppression of fetal breathing, limb and trunk movements, resulting in decreased biophysical profile scores. Awareness of this drug-induced effect might prevent unnecessary iatrogenic delivery of preterm fetuses.
BETAMETHASONE (bay ta METH a sone) is a corticosteroid. It helps to reduce swelling, redness, itching, and allergic reactions. It is used to treat asthma, allergies, arthritis, Crohn's disease, and ulcerative colitis. It is also used for other conditions, like blood disorders and diseases of the adrenal glands.
