SBA — Single Best Answer · Review
Question 40
Feto-maternal medicine → Maturity
Classification
Question
SSBAWhat is the most appropriate management?
Options
Explanation
Antenatal corticosteroids should not be withheld solely because preterm birth is expected within 24 hours. Neonatal mortality may be reduced even when corticosteroids are administered shortly before birth, with benefit demonstrated within the first 24 hours after treatment. The greatest benefit is generally seen when birth occurs after sufficient time for treatment, particularly within the 24-hour to 7-day interval, but inability to achieve that interval is not a reason to withhold treatment when imminent preterm birth is anticipated.
Option Validity
A) Antenatal corticosteroids may still provide neonatal benefit when birth occurs within 24 hours of the first dose.
C) A full corticosteroid course does not need to be completed before birth for treatment to be worthwhile.
D) Delivery should not be delayed solely to complete or optimise a corticosteroid course when birth is otherwise indicated or labour is progressing.
E) Treatment should not be deferred until the optimal interval is certain, because benefit may occur even when birth follows shortly after administration.
Further Reading
Stock SJ, Thomson AJ, Papworth S, on behalf of the Royal College of Obstetricians and Gynaecologists. Antenatal corticosteroids to reduce neonatal morbidity and mortality. BJOG. 2022;129:e35–e60. RCOG Green-top Guideline No. 74. doi:10.1111/1471-0528.17027.