Steroids and PTL

Question 1

Gestations to give steroids

Answer 1

22- 23+6- Discuss with NNU
24-34+6- Give
35-36+6- Consider

37-38+6 - Delivery by CS, discuss,
Benefits- Red NNU admission for resp distress.
No change in RDS, TTN, overall NNU admission.
Risk of devel. delay and hypoglycaemia.

Question 2

Benefits of steorids

Answer 2

Best if given 24-48h before birth, up to 7 days

Red perinatal and neonatal death
Red- RDS
IVH
Developmental delay

Question 3

Risks of steroids

Answer 3

Inc mat BG
Can reduced birth weight if delivery >7days after
Neonatal hypoglycaemia

Question 4

Doses of steroids

Answer 4

Dexamethasone 24mg in 2 or 4 doses
Betamethasone phosphate 24mg in 2 doses

Question 5

PPROM %

Answer 5

Affects 3-4% of preg
Causes 30-40% PTB

Question 6

Timing of PROM to delivery

Answer 6

7 days average
If does not deliver- IOL 37 weeks

Question 7

SROM Abx cover

Answer 7

Erythromycin 10 days
IV Benpen or Cefotaxime or Vanc in labour

Question 8

MgSO4 timing

Answer 8

24-29+6- Give
30-33+6- consider

4g stat then 1g/h

Question 9

Tocolysis

Answer 9

Do not give if SROM

24-25+6- consider
26- 33+6- Give

Question 10

Monitoring in PTB

Answer 10

CTG- continuous in active labour
DO NOT use FSE <34 weeks