الفهرس 
Term FetusOnly 14 pages are availabe for public view
 |  | from | 185 |  |  |
| | | from | 185 | | |
Abstract
Caesarean section rate has been increased, half of which are elective. This may be due to abnormal presentation during pregnancy, increased maternal choice about mode of delivery and due to changing practice in the management of previous caeserean sections.
Aim of the work: The objective of this study is to assess the effect of prophylactic dexamethasone 48h before elective cesarean section at term (less than 39 weeks) on decreasing the neonatal respiratory distress syndrome and NICU admission.
Patients and Methods: Design: A randomized controlled clinical trial. 2 groups; (group A, Dexa) which consists of 460 pregnants who received prophylactic 4 intramuscular doses of 6mg dexamethasone 12 hours apart 48 hours before delivery. And (Groups B, Control) 460 pregnants who received No treatment before elective caesarean section at term (37-39wks).
Results: Regarding the indication for the C.S, there was no significant difference between women of both groups. There was no significant statistical difference between the two groups as regarding birth weight. Neonates of dexamethasone group significantly had higher APGAR scores. Transient tachypnea of neonates (TTN) was significantly less frequent among dexamethasone group (2.8%) while in the control group was (6.5%). Respiratory distress syndrome (RDS) was significantly less frequent among dexamethasone (A) group 3/460 (0.7%) while was 15/460 (3.3%) in control (B) group. Also (RDS) grade was significantly less frequent among dexamethasone group. The intraventricular hemorrhage was non-significantly less frequent among dexamethasone group (0.2%). The need to resuscitation was significantly less frequent among dexamethasone group (6.3%) while in control group was (11.5%). NICU admission was significantly less frequent among dexamethasone group (3.5%) vs (9.1%) in control group. Also NICU admission duration was significantly shorter among dexamethasone group. The need for mechanical ventilation was significantly less frequent among dexamethasone group (0.2%) while in control group was (1.7%). Mechanical ventilation duration was significantly shorter among dexamethasone group. Neonatal mortality was non-significantly less frequent among dexamethasone group (0.2%) while in control group (0.4%).
Conclusion: Antenatal Corticosteroids are effective in prevention of respiratory complications after elective caesarean section at term including: the incidence of neonatal respiratory distress syndrome, the incidence of admission with respiratory distress to neonatal ICU and the incidence of transient tachyponea of the newborn.