Edit Question 54

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Obstetrics and Gynaecology →Clinical →Feto-maternal medicine →Maturity →Related issue →Steroid →Timing

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Antenatal corticosteroid treatment should not be withheld merely because preterm birth appears likely within 24 hours. Benefit can occur even after a short interval between the first dose and birth. Observational evidence demonstrates reduced neonatal mortality when corticosteroids are given before preterm birth, with the largest effect generally seen when birth occurs between approximately 24 hours and seven days after treatment. However, a significant mortality reduction has also been demonstrated at shorter intervals, including within 24 hours. Consequently, the opportunity to provide some fetal exposure should not be lost simply because a full course is unlikely to be completed. At 30+1 weeks this woman is well within the gestational range for which corticosteroids are recommended. The correct approach is therefore to administer the first dose promptly while continuing appropriate obstetric management. Treatment should not depend on fetal lung maturity testing or on the ability to postpone birth for an arbitrary minimum interval.

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