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    Antenatal Corticosteroids in Preterm Labour PDF

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    Sanjay Rabde
    This document provides guidelines for the preparation, dosage, indications, and contraindications of dexamethasone injections for pregnant women between 24-34 weeks gestation. It states that dexamethasone sodium phosphate is available as a 4 mg/ml injection. The recommended dose is 6 mg administered intramuscularly every 12 hours for a total of 4 doses or 24 mg. Frank chorioamnionitis is an absolute contraindication, while conditions like diabetes and hypertension are not. A flow chart outlines the assessment and administration process depending on whether the woman is in true preterm labor.

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    Antenatal Corticosteroids in Preterm Labour PDF

    Uploaded by

    Sanjay Rabde
    108 views3 pages
    This document provides guidelines for the preparation, dosage, indications, and contraindications of dexamethasone injections for pregnant women between 24-34 weeks gestation. It states that dexamethasone sodium phosphate is available as a 4 mg/ml injection. The recommended dose is 6 mg administered intramuscularly every 12 hours for a total of 4 doses or 24 mg. Frank chorioamnionitis is an absolute contraindication, while conditions like diabetes and hypertension are not. A flow chart outlines the assessment and administration process depending on whether the woman is in true preterm labor.

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    Antenatal Corticosteroids in Preterm Labour(1).pdf

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    This document provides guidelines for the preparation, dosage, indications, and contraindications of dexamethasone injections for pregnant women between 24-34 weeks gestation. It states that dexamethasone sodium phosphate is available as a 4 mg/ml injection. The recommended dose is 6 mg administered intramuscularly every 12 hours for a total of 4 doses or 24 mg. Frank chorioamnionitis is an absolute contraindication, while conditions like diabetes and hypertension are not. A flow chart outlines the assessment and administration process depending on whether the woman is in true preterm labor.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    108 views3 pages

    Antenatal Corticosteroids in Preterm Labour PDF

    Uploaded by

    Sanjay Rabde
    This document provides guidelines for the preparation, dosage, indications, and contraindications of dexamethasone injections for pregnant women between 24-34 weeks gestation. It states that dexamethasone sodium phosphate is available as a 4 mg/ml injection. The recommended dose is 6 mg administered intramuscularly every 12 hours for a total of 4 doses or 24 mg. Frank chorioamnionitis is an absolute contraindication, while conditions like diabetes and hypertension are not. A flow chart outlines the assessment and administration process depending on whether the woman is in true preterm labor.

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    © All Rights Reserved
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    Download as pdf or txt
    of 3

    Annexure:- I

    Preparation and Dosage of Dexamethasone

    Preparation

    Injection
    Dexamethasone Sodium
    Phosphate is available in
    4 mg per ml strength.

    Table 1: Dose and Route of Administration of


    Injection Dexamethasone
    Dose 6 mg each
    No. of Injections 4
    Interval between injections 12 hours
    Route of administration Deep Intramuscular
    Site of administration Preferably antero lateral aspect of thigh
    Complete course Four doses (equivalent to 24 mg total)
    Logistics 2 ml disposable syringes and 22/23 gauge needles
    Storage No need to refrigerate

    The 6 mg dose would require 1.5 ml of the preparation provided each ml has 4 mg
    of Dexamethasone.

    6
    Table 2: Indications and Contraindications for using
    Corticosteroids in Antenatal Period
    Indications Contraindications
    1. True preterm labour Frank chorioamnionitis is an absolute
    2. Following conditions that lead to contraindication for using antenatal
    imminent delivery: corticosteroids. Following signs and
    symptoms in the mother suggests Frank
    • Antepartum haemorrhage
    amnionitis:
    • Preterm premature rupture of
    1. History of fever and lower abdominal
    membrane
    pain
    • Severe pre-eclampsia
    2. On examination: Foul smelling vaginal
    discharge, tachychardia and uterine
    tenderness
    3. Fetal tachycardia

    Maternal diabetes, pre-eclampsia and hypertension are NOT contraindications


    for using injection corticosteroid in pregnant women. Dexamethasone can be
    administered if otherwise indicated with a careful watch on blood sugar and blood
    pressure [If chorioamnionitis is suspected, consider delivering the baby].

    7
    Flow Chart for Antenatal Corticosteroid (ANCS) Administration {24-34 Weeks Gestational Age}

    Assess the gestational age of pregnant woman reporting with the complaints of labour pain.
    If between 24-34 weeks then

    Check whether the pregnant woman is in true preterm labour using


    the table* given below:

    If the pregnant woman is in true labour If the pregnant woman is not in true labour

    Observe for the symptoms, discharge


    Delivery imminent Delivery NOT imminent if the symptoms resolve with advice
    to report immediately if danger
    Give one dose of Injection Give one pre-referral dose of signs appear.
    Dexamethasone as described Injection Dexamethasone if the If symptoms do not resolve, treat her
    in the box** and prepare for patient is to be referred, otherwise as in true preterm labour and follow
    delivery and neonatal complete the course. Tocolysis (delay the chart.
    resuscitation of uterine contractions) is to be
    done under medical supervision.

    Before referral Referral refused or not possible **Dexamethasone protocol


    1. Check vitals, BP 1. Check vitals, BP Dose/injection 6 mg
    2. Do Hb, Blood Sugar, 2. Do Hb, Blood Sugar, Urine Ex.
    Urine Examination (Ex) 3. Give ANCS first dose, then Route Intramuscular
    3. Give ANCS first dose - 3 additional doses 12 hourly
    Refer to higher facility 4. Arrange for delivery, Interval 12 hours
    4. Arrange transport resuscitation and care of
    5. Referral slip preterm baby No. of Injections 4

    Contraindication for use of ANCS is Frank Chorioamnionitis


    *Symptoms of True and False Labour Pain
    TRUE Labour Pain FALSE Labour Pain
    1. Begins irregularly but becomes regular and predictable 1. Begins irregularly and remains irregular
    2. Felt first in the lower back and sweeps around to the 2. Felt first abdominally and remains confined
    abdomen in a wave pattern to the abdomen and groin
    3. Continues no matter what the woman’s level of activity 3. Often disappears with ambulation or sleep
    4. Increases in duration, frequency and intensity with the 4. Does not increase in duration, frequency or
    passage of time intensity with the passage of time
    5. Accompanied by ‘show’ (blood-stained mucus discharge) 5. Show absent
    6. Associated with cervical effacement and cervical 6. Does not associate cervical effacement and
    dilatation cervical dilatation

    11

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