What is the role of corticosteroids in the management of premature rupture of membranes (PROM)?

Updated: Oct 05, 2018
  • Author: Allahyar Jazayeri, MD, PhD, FACOG, DACOG, FSMFM; Chief Editor: Carl V Smith, MD  more...
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The use of corticosteroids to accelerate lung maturity should be considered in all patients with PPROM with a risk of infant prematurity from 24-34 weeks' gestation. The latency period has been suggested to be too short for the effects of corticosteroids to make a difference in neonatal morbidity; however, this clearly does not appear to be the case. Most patients with PPROM remain pregnant at 48 hours and thus will benefit from corticosteroid therapy. The use of steroids has also been suggested to increase the risk of infection. However, the current evidence does not support this concern based on individual studies and meta-analyses; no difference (either higher or lower rates of infections) has been observed with corticosteroid use.

In contrast to these concerns, data indicate that the use of corticosteroids reduces neonatal morbidity and mortality. The rates of respiratory distress syndrome (RDS), necrotizing enterocolitis, and intraventricular hemorrhage were all lower when either 12 mg of betamethasone IM was given twice in a 24-hour interval or dexamethasone 6 mg q12h was given for 4 doses. [23]

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