Use of Antenatal Corticosteroids prior to Elective Caesarean Section at Term in Reducing the Incidence of Transient Tachypnoea of the Newborn – A ThreeYear Observational Studyin A Premium Institute.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 9
Abstract
Background: Neonates delivered by elective Caesarean section are found to be associated with an increased risk of respiratory morbidity when compared to their vaginal counterparts; and the risk of respiratory complications, mainly respiratory distress syndrome and transient tachypnoea, decreases from 37 weeks to 39 weeks of gestation1 . The development of respiratory distress leads to admission to a neonatal intensive care unit, separation from the mother, complications from invasive procedures including artificial ventilation and has psychological and financial bearing on the parents.Therefore, Hansen et al concluded that a significant reduction in morbidity would be obtained if elective Caesarean section was deferred to 39 weeks. 2Antenatal corticosteroids reduce the incidence of respiratorydistress in preterm babies. 3 Studies have been conducted to assess the usefulness of antenatal steroids prior to term Caesareans and have shown a promising outcome with regard to a decrease in incidence of respiratory distress and transient tachypnea of the newborn, thereby suggestive that antenatal corticosteroids may have a role in Caesarean sections planned before 39 weeks of gestation.4-6 Objectives:To study the effect of antenatal corticosteroids in term elective Caesarean section in reducing the incidence of Transient Tachypnea of the Newborn. Methodology: This observational study was conducted at Sri Ramachandra Medical College during the study period of August 2013 – August 2016 with a total of 604 term (37 weeks to 39 weeks) women with singleton pregnancies. Out of the 604 women included, 307 were assigned to Group A (those without steroid administration) and 297 to Group B (those with steroid administration). The steroid used was Injection Betamethasone 12mg, administered 24 hours apart, 24 – 48 hours prior to planned surgery. Neonates were diagnosed with Transient Tachypnoea of the newborn (TTN) if they developed clinical features of respiratory distress like tachypnea along with grunting/ chest retraction/ nasal flaring which resolved within 24 hours of birth, after excluding other possible etiologies of distress like respiratory distress syndrome, pneumonia, meconium aspiration syndrome or pneumothorax by the use of imaging studies or laboratory tests, as indicated. Results: In our study, amongst the 307 neonates in Group A, 49 (15.96%) developed TTN and amongst the 297 in Group B, only 13 (4.3%) developed TTN. There was thus a statistically significant (p value<0.001) decrease in the incidence of TTN amongst the neonates in Group B. Conclusion: The use of antenatal corticosteroids prior to elective Caesarean section at term appears to reduce the incidence of Transient tachypnea in the Newborn.
Authors and Affiliations
Dr. Namrita George, Prof. Jaya Vijayaraghavan
Keywords
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- EP ID EP381876
- DOI 10.9790/0853-1709023039.
- Views 25
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