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OB Guideline 11: Use of Antenatal Corticosteroids for Fetal Maturation


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OB Guideline 11: Use of Antenatal Corticosteroids for Fetal Maturation

Related to: Communication, Cures Act: Opening Notes, Nursing, Obstetrics, Teamwork Training

All women between 24 and 34 weeks gestation who are at risk for delivery within seven days, should receive corticosteroids. This includes women with rupture of membranes, unless individual circumstances affect this decision.

Treatment options include:

  • two doses of betamethasone 12 mg IM 24 hours apart, or
  • four doses of dexamethasone 6 mg IM 12 hours apart.

The 2000 NIH Consensus panel did not find significant evidence to support using one drug preferentially over the other.

A second course of antenatal corticosteroids may be considered if clinically appropriate.1  Further repeat courses should be reserved for women enrolled in clinical trials. Administration of steroids between 34⁰⁄₇ weeks and 365⁄₇ weeks necessitates careful consideration of the risks, benefits, and unknowns. Tocolysis beyond 34 weeks gestation to complete steroid administration is not recommended.2

  1. Management of preterm labor. ACOG Practice Bulletin No. 127. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2012;119:1308–17. 
  2. Gyamfi-Bannerman, et al. Antenatal betamethasone for women at risk for late preterm delivery. New England Journal of Medicine. 2016;374(14):1311–20.
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December 20, 2017
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