A pregnant mother at 32 weeks gestation presents in preterm labour. Therapy with antenatal steroids to induce lung maturity in the fetus may be given in all of the following conditions except :
Ans. Is d i.e. Chorioamnionitis "Coicosteroids can be given even in presence of maternal hypeension or diabetes mellitus, but should preferably be avoided if PROM is associated with definitive evidence of chorioamnionitis" "Steroid treatment is contraindicated in presence of ove infection." ... Fernando Arias 3/e, p 220 Steroid therapy in preterm labour : Steroids are recommended for all women in preterm labour before 36 weeks. Advantage : Steroids reduce the rate of respiratory distress syndrome and intraventricular hemorrhage in the newborn. The effect of treatment is maximal between 24 hours of the first dose and uptil 7 days. Earlier it was recommended to give repeated doses weekly till the patient delivers but this practice is associated with significant fetal and neonatal side effects like cerebral palsy and should be abandoned. Betamethasone is the steroid of choice and the recommendation is to give two doses of 12 mg intramuscularly 24 hours apa.
Prolonged rupture of membranes for more than 24 hours
Pregnancy induced hypeension
Diabetes mellitus
Chorioamnionitis