Abstract
Preterm premature rupture of membranes is an important cause of preterm delivery. Management includes antibiotic therapy and a course of steroids. Current approach is to give two doses of steroid betamethasone 24 hours apart. We recruited 100 women with pPROM between 26-34 weeks period of gestation, divided into two groups of 50 each, receiving betamethasone two doses either 12 hours or 24 hours apart. Aim was to see difference in outcome of Respiratory distress syndrome (RDS) and other morbidities like intraventricular heamorrhage (IVH), necrotizing enterocolitis (NEC) and Neonatal sepsis. We found no statistical difference in the outcome of RDS and other morbidities except birth asphyxia. We concluded that women with Pprom can be offered course of steroids with 12 hour interval. Moreover it had the advantage of having more women completing the course of steroids before delivery.
Keywords: Preterm premature rupture of membranes (pPROM), respiratory distress syndrome (RDS), steroid, betamethasone.
References
1. Singh U, Singh N, Shikha S. A prospective analysis of etiology and outcome of preterm labor. J Obstet and Gynecol.2007; 57: 48-52.
- Brownfoot FC, Crowther CA, Middleton P. Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst. Rev 2008; 4.
- Canavan TP, Simhan HN, Caritis S. An evidence-based approach to the evaluation and treatment of premature rupture of membranes:Part I. Obstet Gynecol Surv.2004;59(9):669-77.
- Dale PO, Tanbo T, Bendvold E, Moe N. Duration of the latency period in preterm premature rupture of the membranes: Maternal and neonatal consequences of expectant management. Eur J Obstet Gynecol Reprod Biol.1989;30(3):257-62.
- Jobe AH, Nitsos I, Pillow JJ, Polglase GR, Kallapur SG, Newnham JP. Betamethasone dose and formulation for induced lung maturation in fetal sheep. Am J Obstet Gynecol.2009;201:611.
- Khandelwal M, Chang E, Hansen C, Hunter K,Milcarek. Betamethasone dosing interva:12 or 24 hrs apart?A randomised,non inferiority open trial. Am J Obstet Gynecol.2012;206:201.
- Kashania M, Eshraghi N, Sheikhansari N, Boardbar A. Comparison between two doses of betamethasone administration with 12 hours vs 24 hours intervals on prevention of respiratory distress syndrome: a randomized trial;Jour Obs& Gynecol.38(6):1-7.March 2018.
- Hass DM, McCullough W, Olsen CH, Shiau DT, Richard J, Fry EA et al. Neonatal outcomes with different betamethasone dosing regimen:a comparison. J Reprod.Med.2005 Dec;50(12):915-22.
Corresponding Author
Dr Sandeep Sharma
Senior Resident, Department of OBG, Indira Gandhi Medical College, Shimla, HP, India