Appropriate antenatal corticosteroid use in women at risk for preterm birth before 34 weeks of gestation.

Hdl Handle:
http://hdl.handle.net/10147/217194
Title:
Appropriate antenatal corticosteroid use in women at risk for preterm birth before 34 weeks of gestation.
Authors:
Mahony, R; McKeating, A; Murphy, T; McAuliffe, F; O'Herlihy, C; Foley, M
Affiliation:
National Maternity Hospital Dublin, Holles Street, Dublin 2, Ireland.
Citation:
Appropriate antenatal corticosteroid use in women at risk for preterm birth before 34 weeks of gestation. 2010, 117 (8):963-7 BJOG
Journal:
BJOG : an international journal of obstetrics and gynaecology
Issue Date:
Jul-2010
URI:
http://hdl.handle.net/10147/217194
DOI:
10.1111/j.1471-0528.2010.02590.x
PubMed ID:
20465556
Abstract:
To determine the utilisation of antenatal corticosteroid administration in women presenting at risk of preterm birth (PTB) in a centre where tocolytics are not prescribed.; A prospective cohort study.; Tertiary referral centre, Dublin, Ireland.; Four hundred and fourteen consecutive women presenting at risk of PTB.; Clinical details were collated prospectively on all booked patients who presented at risk of PTB (i.e. at <34 weeks of gestation) during 2008.; Rate of administration of antenatal corticosteroids in PTB.; Of 8985 deliveries, 414 women (5%) presented at <34 weeks of gestation with a clinical potential for PTB, of whom 277 (67%) received antenatal corticosteroids. Amongst women delivering at <34 weeks of gestation, 93% (80/86) received any corticosteroids and 76% (65/86) received a complete course. The ratio of women given a complete course of corticosteroids to the number who actually delivered before 34 weeks of gestation was 4:1 overall. Analysis by indication for PTB revealed this ratio to be 15:1 in suspected preterm labour (PTL), 8:1 in antepartum haemorrhage (APH), and 2:1 in both preterm prelabour rupture of membranes (PPROM) and medically indicated PTB (MIPTB). Seven of ten multiparae (70%) who delivered prematurely during the study period following PTL had a history of previous PTL before 34 weeks of gestation.; The ratio of maternal antenatal corticosteroid administration for potential versus actual PTB at <34 weeks of gestation was high in categories such as PTL and substantial APH, whereas selection in PPROM and MIPTB approached 100%. There should be a low threshold for single course therapy for women with prior PTL before 34 weeks of gestation.
Language:
en
MeSH:
Adrenal Cortex Hormones; Female; Fetal Membranes, Premature Rupture; Hemorrhage; Humans; Ireland; Pregnancy; Pregnancy Complications, Cardiovascular; Premature Birth; Prenatal Care; Prospective Studies; Risk Factors
ISSN:
1471-0528
Ethical Approval:
N/A

Full metadata record

DC FieldValue Language
dc.contributor.authorMahony, R-
dc.contributor.authorMcKeating, A-
dc.contributor.authorMurphy, T-
dc.contributor.authorMcAuliffe, F-
dc.contributor.authorO'Herlihy, C-
dc.contributor.authorFoley, M-
dc.date.accessioned2012-03-30T14:00:24Z-
dc.date.available2012-03-30T14:00:24Z-
dc.date.issued2010-07-
dc.identifier.citationAppropriate antenatal corticosteroid use in women at risk for preterm birth before 34 weeks of gestation. 2010, 117 (8):963-7 BJOG-
dc.identifier.issn1471-0528-
dc.identifier.pmid20465556-
dc.identifier.doi10.1111/j.1471-0528.2010.02590.x-
dc.identifier.urihttp://hdl.handle.net/10147/217194-
dc.description.abstractTo determine the utilisation of antenatal corticosteroid administration in women presenting at risk of preterm birth (PTB) in a centre where tocolytics are not prescribed.-
dc.description.abstractA prospective cohort study.-
dc.description.abstractTertiary referral centre, Dublin, Ireland.-
dc.description.abstractFour hundred and fourteen consecutive women presenting at risk of PTB.-
dc.description.abstractClinical details were collated prospectively on all booked patients who presented at risk of PTB (i.e. at <34 weeks of gestation) during 2008.-
dc.description.abstractRate of administration of antenatal corticosteroids in PTB.-
dc.description.abstractOf 8985 deliveries, 414 women (5%) presented at <34 weeks of gestation with a clinical potential for PTB, of whom 277 (67%) received antenatal corticosteroids. Amongst women delivering at <34 weeks of gestation, 93% (80/86) received any corticosteroids and 76% (65/86) received a complete course. The ratio of women given a complete course of corticosteroids to the number who actually delivered before 34 weeks of gestation was 4:1 overall. Analysis by indication for PTB revealed this ratio to be 15:1 in suspected preterm labour (PTL), 8:1 in antepartum haemorrhage (APH), and 2:1 in both preterm prelabour rupture of membranes (PPROM) and medically indicated PTB (MIPTB). Seven of ten multiparae (70%) who delivered prematurely during the study period following PTL had a history of previous PTL before 34 weeks of gestation.-
dc.description.abstractThe ratio of maternal antenatal corticosteroid administration for potential versus actual PTB at <34 weeks of gestation was high in categories such as PTL and substantial APH, whereas selection in PPROM and MIPTB approached 100%. There should be a low threshold for single course therapy for women with prior PTL before 34 weeks of gestation.-
dc.language.isoen-
dc.rightsArchived with thanks to BJOG : an international journal of obstetrics and gynaecologyen_GB
dc.subject.meshAdrenal Cortex Hormones-
dc.subject.meshFemale-
dc.subject.meshFetal Membranes, Premature Rupture-
dc.subject.meshHemorrhage-
dc.subject.meshHumans-
dc.subject.meshIreland-
dc.subject.meshPregnancy-
dc.subject.meshPregnancy Complications, Cardiovascular-
dc.subject.meshPremature Birth-
dc.subject.meshPrenatal Care-
dc.subject.meshProspective Studies-
dc.subject.meshRisk Factors-
dc.titleAppropriate antenatal corticosteroid use in women at risk for preterm birth before 34 weeks of gestation.en_GB
dc.contributor.departmentNational Maternity Hospital Dublin, Holles Street, Dublin 2, Ireland.-
dc.identifier.journalBJOG : an international journal of obstetrics and gynaecology-
dc.type.qualificationlevelN/Aen
cr.approval.ethicalN/Aen
dc.description.provinceLeinsteren
dc.description.provinceLeinster-

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