Antenatal Corticosteroid Therapy in Management of Preterm Labor Caused by Preterm Premature Rupture of Membranes – Risks and Benefits

Abstract:Preterm labor is a common complication of pregnancy, in one third of the cases it is caused by preterm premature rupture of membranes (PPROM). Since the crucial article by Liggins and Howie published in 1972, antenatal corticosteroid therapy has played a prominent role in the management of preterm labor. Nowadays plenty of studies have shown the effectiveness of the therapy in reducing neonatal mortality and morbidity. However, there is some ambiguity about the therapy in certain cases, including PPROM. The immunosuppressive activity of steroids is widely known. Even though the corticosteroids generally used in the management of preterm labor (betamethasone, dexamethasone) show very weak immunosuppressive activity, there is still some doubt -regarding the possible increase in risk of neonatal and maternal infection. Other questions concern the effectiveness of the therapy in this group of patients, as well as current recommendation of main obstetricians’ societies and safety of use of repeated doses. The aim of this article is to highlight the latest knowledge in this area.

Authors:

Tondys-Kohmann Ewa1, Zareba-Szczudlik Julia, Romejko-Wolniewicz Ewa.

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