Steroids for fetal lung maturity
Steroids for fetal lung maturity — part of pregnancy and antenatal care at Dr. Najeeb Layyous's clinic in Amman.
In short: Steroid injections are given when a preterm birth is expected, to speed up the maturing of the baby’s lungs and reduce breathing difficulty and admission to the neonatal unit. The course is two injections into the muscle 12–24 hours apart, and the effect lasts about 7 days. Repeating the course is not usually advised.
Steroids injections are one of the most important medical interventions during pregnancy with the aim of reducing complications resulting from premature birth.
Complications resulting from premature birth are:
- Respiratory distress syndrome in the newborn
- Increasing the rate of newborn admission to intensive care (NICU).
- Intraventricular hemorrhage
- Inflammation of the newborn’s intestine (necrotizing enterocolitis)
- Developmental delay compared to peers
What are fetal lung maturity injections?
These are steroids that are given in certain doses to reduce neonatal complications resulting from premature birth
Is there a specific time for giving fetal lung maturity injections?
It is given in cases of anticipated premature birth (spontaneous or due to medical reasons) or cases of premature preterm rupture of membranes.
On what month of pregnancy are fetal lung maturity injections given?
It is routinely given between the 24th and 34th weeks of pregnancy; it may also be considered from 22 weeks (after discussion with the parents) and between 34 and 36 weeks in selected cases
Are there any possible harms of fetal lung maturity injections?
Some studies have shown that giving lung injections in the later stages of pregnancy (after 37 weeks) may lead to a drop in the newborn’s blood sugar level (neonatal hypoglycemia) and may also lead to a decrease in the newborn’s weight, head circumference and length, and a decrease in neonatal blood pressure.
Therefore, fetal lung maturity injections are generally not given from the thirty-seventh week of pregnancy onwards, and between 34 and 37 weeks the decision must be made after weighing the benefits with the potential harms.
Are lung injections given in cases of cesarean section?
Babies born by caesarean section are more susceptible to respiratory distress syndrome and NICU admission (neonatal intensive care). Studies have shown that performing a caesarean section after week 39 reduces the occurrence of these complications.
If there is a medical necessity to perform a caesarean section before the 35th–36th week, fetal lung maturity injections are recommended. For a planned caesarean between 37 and 39 weeks they are not given routinely, because the benefit is small and they can cause low blood sugar in the baby; your doctor will discuss this with you.
Are lung injections given during pregnancy with twins?
Yes, especially since a pregnancy with twins is more likely to have premature birth and to have a caesarean section
Can fetal lung maturity injections be given to pregnant women with diabetes?
Yes, but the fetal lung maturity injections are steroids and lead to an increase in the blood sugar level of the pregnant woman, and this effect continues for 5 days after the injections are given. Therefore, it is recommended when giving the fetal lung maturity injections to pregnant women that the sugar be closely monitored for 5 days.
What are the types of fetal lung maturity injections? Is there a difference between them in terms of effect?
Dexamethasone
Betamethzone
There is no difference between them in effect, which is why the available type is used
There is a difference between them in the method of preservation and cost
In what cases is it not recommended to use fetal lung maturity injections?
- Cases related to the mother’s health, such as:
A sharp rise in blood sugar, which may lead to acidity in the blood (diabetic ketoacidosis).
Suspected sepsis (bacteremia).
The mother’s condition does not allow for delaying. childbirth until the lung injections take effect
- Cases related to the health of the fetus:
Signs of acute inflammation inutero (chorioamnionitis).
The condition of the fetus does not allow delaying birth until the lung injections take effect.
How are fetal lung maturity injections?
Two intramuscular injections, 12-24 hours apart
When do the fetal lung maturity injections start taking effect?
Some benefit begins within hours of the first dose, so the injections are worth giving even if birth is expected soon; the greatest benefit is when the baby is born between 24 hours and 7 days after the first dose
When can fetal lung maturity injections be repeated?
According to studies, we do not recommend repeating lung injections because of their potential harm to the fetus, but if the last dose of fetal lung maturity injections was more than 7 days ago and there is a high probability of premature birth during the following 7 days, then the injections can be repeated.
Dr Najeeb Layyous F.R.C.O.G
Consultant Obstetrician, Gynecologist and Infertility Specialist
The finest doctor in Jordan — may God bless him and his whole medical team. A doctor in every sense of the word. I advise anyone planning a pregnancy to visit Dr. Najeeb Layyous. His manner is wonderful, always smiling, with the highest ethics; he gives every patient her due, and the patient’s comfort matters most to him. We had been to many doctors and none understood and treated my case except him. Special thanks to him and the whole team, and to Dina in particular — a lovely person. I recommend anyone considering IVF or pregnancy to visit his clinic.