Objectives: To evaluate the effect of prenatal dexamethasone administration on the frequency and severity of neonatal respiratory complications of elective cesarean section (CS) around 37 weeks gestational age (GA).
Design: Prospective randomized trial.
Setting: Departments of Gynecology and Obstetrics, and Pediatrics, Faculty of Medicine, Benha University.
Patients & Methods: The study included 610 multigravida women assigned for repeated CS around 37 weeks. Parturient were randomly divided into two equal groups: Group A (Study Group) assigned to receive two intramuscular dexamethasone injections (12 mg each) 12-hours prior to and immediate preoperative. Group B (Control group) received no dexamethasone priming. The frequency of neonatal respiratory complications was recorded as frequency and severity and included any respiratory distress, transient tachypnoea of the newborn and persistent pulmonary hypertension of the newborn. Serious respiratory morbidity was defined as that requiring treatment for ≥3 days with continuous oxygen supplementation.
Results: Forty six neonates (7.5%) developed respiratory complications; 34 in Group B (10.9%) and 12 in Group A (4%). Prenatal corticosteroid regimen significantly reduced the frequency of respiratory complications compared to those had CS without prenatal corticosteroid. There was significantly higher frequency of respiratory complications in obese versus overweight mothers, irrespective of prenatal administration of dexamethasone. Transient tachypnoea of the newborn was recorded in 39 neonates; 28 in Group B and 11 in Group A, while 7 neonates had serious respiratory morbidity with significantly lower frequency in those exposed to dexamethasone.
Conclusion: Prenatal intramuscular injection of dexamethasone (12 mg) 12-hr prior to and at time of elective CS significantly and safely ameliorated the frequency and severity of neonatal respiratory complications after elective CS around 37 weeks GA.
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