الفهرس 
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Abstract
During the first 36 to 38 weeks of normal gestation, the myometrium is in a preparatory yet unresponsive state. Concurrently, the cervix begins an early stage of remodeling yet maintains structural integrity.
Following this prolonged uterine quiescence, a transitional phase follows during which myometrial unresponsiveness is suspended and the cervix undergoes ripening, effacement, and loss of structural cohesion.
Cervical ripening is a complex process involving extensive remodeling and dynamic anatomic and physiologic alternations governed by hormonal changes, inflammatory responses, vasodilatory changes, and other biological processes.
Prostaglandins, produced both locally in the cervix and uterus as well as originating from the fetal membranes, play a critical role in cervical ripening and uterine contractility by increasing inflammatory mediators in the cervix and inducing cervical remodeling.
Induction of labor is the process by which labor is started by its spontaneous onset by artificial stimulation of uterine contractions and/or progressive cervical effacement and dilatation, leading to active labor and birth. The clinical need for induction of labor occurs when the outcome of the pregnancy would be improved if it is interrupted by induction, labor and birth.
Steroid substances produced in the adrenal glands of human fetus affect the placenta and the membranes and transform the myometrium from the static to the contractile state. The placenta may play a role in this process because it produces a lot of CRH (Corticotropin releasing hormone).
The adrenal glands of the fetus do not produce a considerable amount of cortisol until the third trimester. During the last weeks of pregnancy, the cortisol and DHEA-S (Dehydroepiandrosterone sulfate) contents of the fetus rise and this leads to an increase in maternal estrogens, a particularly sterol. The concentration of CRH in the fetus rises during the last 12 weeks of pregnancy. This results in modification of the contractility of the uterus, stimulation to produce C19 steroids from placental adrenaline, and increase in the estrogen content.
Studies have shown that corticosteroids analogues as dexamethasone could improve the Bishop score of the cervix and thus causes softening of the cervix and reduces the length of time between labor induction and delivery but further studies in that field is still needed.
This randomized control trial was conducted at department of obstetrics and gynecology at Ain Shams University Maternity Hospital (ASUMH) in the period between August 2020 and January 2021.
This study assessed the effect of intravenous administration of dexamethasone on the induction delivery interval in term patients with prelabour rupture of membranes undergoing induction of labor.
The participants of this study were 80 full term pregnant women with pre-labor rupture of membranes attended the labor ward in El Demerdash Maternity Hospital and scheduled for induction of labor by 8 mg dexamethasone IV under cover of broad spectrum antibiotics. Patients were divided into two groups:
• group (D): 40 women received 8 mg (2 ml) of the product dexamethasone sodium phosphate intravenous one hour before the initiation of labor induction in the form of Epidrone® ampoules which is a dexamethasone product from Epico-Egypt, and labor induction was performed according to the American College of Obstetricians and Gynecologists protocol
• group C (control group): 40 women labor received 2 ml of normal saline intravenous one hour before the initiation of labor induction, and labor induction was performed according to the American College of Obstetricians and Gynecologists protocol.
Statistical analysis of current study showed that there were no significant differences between women of both groups regarding age, BMI, gestational age and BISHOP score. Fetal distress, arrest of delivery and indications of CS delivery were non-significantly less frequent among Dexamethasone group. Induction - active phase and active phase durations were significantly shorter among dexamethasone group than among control group. Second and third stages durations were non-significantly shorter among dexamethasone group than among control group. Total induction-delivery duration was significantly shorter and rate of delivery was significantly higher among dexamethasone group than among control group. There were no significant differences between dexamethasone and control groups regarding neonatal condition as birth weight, APGAR 1 and 5 minutes and need for NICU admission. Postpartum hemorrhage (PPH) was not reported among the studied groups.