Steroids for fetal lung maturity

Steroids for fetal lung maturity

Steroids injections are one of the most important medical interventions during pregnancy with the aim of reducing complications resulting from premature birth.

Complications resulting from premature birth are:

**Respiratory distress syndrome in the newborn

**Increasing the rate of newborn admission to intensive care (NICU).

**Intraventricular hemorrhage

** Inflammation of the newborn's intestine (necrotizing enterocolitis)

**Developmental delay compared to peers

What are fetal lung maturity injections?

These are steroids that are given in certain doses to reduce neonatal complications resulting from premature birth 

Is there a specific time for giving fetal lung maturity injections?

It is given in cases of anticipated premature birth (spontaneous or due to medical reasons) or cases of premature preterm rupture of membranes.

On what month of pregnancy are fetal lung maturity injections given?

It is given between the 24th and 35th weeks of pregnancy

Are there any possible harms of fetal lung maturity injections?

Some studies have shown that giving lung injections in the later stages of pregnancy (after 37 weeks) may lead to a drop in the newborn’s blood sugar level (neonatal hypoglycemia) and may also lead to a decrease in the newborn’s weight, head circumference and length, and a decrease in neonatal blood pressure.

Therefore, the decision to give fetal lung maturity injections after the thirty-seventh week of pregnancy must be made after weighing the benefits with the potential harms.

Are lung injections given in cases of cesarean section?

Babies born by caesarean section are more susceptible to respiratory distress syndrome and NICU admission (neonatal intensive care). Studies have shown that performing a caesarean section after week 39 reduces the occurrence of these complications.

If there is a medical necessity to perform a caesarean section before the thirty-ninth week, it is recommended to give fetal lung maturity injections to reduce the rate of NICU admission and reduce the incidence of respiratory distress in the newborn.

Are lung injections given during pregnancy with twins?

Yes, especially since a pregnancy with twins is more likely to have premature birth and to have a caesarean section

Can fetal lung maturity injections be given to pregnant women with diabetes?

Yes, but the fetal lung maturity injections are steroids and lead to an increase in the blood sugar level of the pregnant woman, and this effect continues for 5 days after the injections are given. Therefore, it is recommended when giving the fetal lung maturity injections to pregnant women that the sugar be closely monitored for 5 days.

What are the types of fetal lung maturity injections? Is there a difference between them in terms of effect?

Dexamethasone

Betamethzone

There is no difference between them in effect, which is why the available type is used

There is a difference between them in the method of preservation and cost

In what cases is it not recommended to use fetal lung maturity injections?

** Cases related to the mother’s health, such as:

A sharp rise in blood sugar, which may lead to acidity in the blood (diabetic ketoacidosis).

Suspected sepsis (bacteremia).

The mother's condition does not allow for delaying. childbirth until the lung injections take effect

** Cases related to the health of the fetus:

Signs of acute inflammation inutero (chorioamnionitis).

The condition of the fetus does not allow delaying birth until the lung injections take effect.

How are fetal lung maturity injections?

Two intramuscular injections, 12-24 hours apart

When do the fetal lung maturity injections start taking effect?

The effect begins 24-48 hours after the second dose and continues for up to 7 days

When can fetal lung maturity injections be repeated?

According to studies, we do not recommend repeating lung injections because of their potential harm to the fetus, 
but if the last dose of fetal lung maturity injections was more than 7 days ago and there is a high probability of premature birth 
during the following 7 days, then the injections can be repeated.

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist