الفهرس 
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Abstract
Labor induction with prostaglandin was known since 1960. Subsequently, formulations of prostaglandin analogues were developed. Misoprostol is a synthetic prostaglandin E1 analogue which is used extensively in obstetric and gynecological applications. In the developed world, the ability to induce labor has contributed to the reduction in maternal and perinatal mortality and morbidity.
During pregnancy, large amounts of CRH are released from the placenta and fetal membranes. An increment in plasma CRH concentration occurs during spontaneous labor, with peak value at vaginal delivery.
Cortisol increases the production of prostaglandins in the fetal membranes by either up regulating prostaglandin endoperoxide synthase 2 (PGHS-2) levels or down regulating prostaglandin dehydrogenase (PGDH).
CRH has been identified in various organ systems, including the female reproductive system, is the principle regulator of the hypothalamic-pituitary-adrenal axis. Circulating placental CRH is responsible for the physiologic hypercortisolism of the latter half of pregnancy and plays a role in the onset of labor.
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Recently, CRH has been shown to stimulate placental production of estrogens and to inhibit placental synthesis of Progesterone.
The increase in the maternal estrogen to progesterone ratio may promote the expression of contraction-associated proteins in the myometrium, thus facilitating the initiation of parturition.
Also, glucocorticoids induce the production of CRH by the placenta and the production of prostaglandins (PGF2 and PGE2) by the fetal membrane in humans. Therefore, glucocorticoids also play an important role in human parturition.
A large number of Steroid analogues have been synthesized including dexamethazone, prednisolone, pridnesone and fludrocortisones.
This study is a randomized double blind, controlled study designed to assess the effect of intramuscular administration of dexamethasone on the progress and the duration of labor. It was conducted in Ain Shams University Maternity Hospital. A total of 80 women undergoing induction of labor were included in this study divided into two groups:
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group D (Study group-Dexamethasone group):
Include 40 patients undergoing induction of labor received 8 mg (2ml) of the product dexamethasone sodium phosphate intramuscularly with the initiation of labor induction.
group C (Control group):
Include 40 patients undergoing induction of labor received 2ml of normal saline intramuscularly with the initiation of labor induction.
In the present study there were no significant statistical differences between the two groups as regard the age, body mass index and gestational age.
Also there were no significant statistical differences between the two groups as regard the pulse (beat per minute), systolic blood pressure, diastolic blood pressure and bishop score at time of intervention.
Dexamethasone group shows shorter duration from initiation of labor induction to the onset of active phase of labor and shorter duration from initiation of labor induction to delivery than control group.
There was a high significant statistical difference between the two groups as regard duration from labor
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induction to the onset of active phase of labor and duration from initiation of labor induction to delivery (p < 0.05).
Our results showed that there was no significant statistical difference was found between the two groups as regard duration of active phase of labor.
There was no significant statistical difference between the two groups as regard duration of 2nd & 3rd stages of labor.
There were no significant statistical differences between the two groups as regards mode of delivery and cesarean section indications.
Our study showed that there was no significant statistical difference between both groups as regarding Apgar score at the first and fifth minutes