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Am J Perinatol 2018; 35(04): 397-404
DOI: 10.1055/s-0037-1607444
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Anticipatory Corticosteroid Administration to Asymptomatic Women with a Short Cervix

Douglas S. Richards
1   Division of Maternal Fetal Medicine, Intermountain Healthcare, University of Utah College of Medicine, Salt Lake City, Utah
,
Luchin F. Wong
2   Swedish Maternal Fetal Specialty Center, Seattle, Washington
,
M. Sean Esplin
1   Division of Maternal Fetal Medicine, Intermountain Healthcare, University of Utah College of Medicine, Salt Lake City, Utah
,
Dave S. Collingridge
3   Statistical Data Center, Intermountain Healthcare, Salt Lake City, Utah
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Publikationsverlauf

19. August 2016

26. September 2017

Publikationsdatum:
03. November 2017 (online)

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Abstract

Objective A short cervix is an important risk factor for spontaneous preterm birth. There is substantial evidence that antenatal exposure to corticosteroids significantly benefits infants that are born when delivery occurs between 24 and 34 weeks' gestation and after 48 hours but within 7 days of their administration. Our study was to evaluate whether asymptomatic women who are given a course of antenatal corticosteroids (ACS) at the time a short cervix is identified deliver within the window of proven steroid benefit.

Study Design This was a retrospective chart review of patients who had a cervical length of < 2.5 cm between 23 and 34 weeks and who did not have cervical dilation or significant symptoms of preterm labor.

Results Of 367 asymptomatic patients with a short cervix, only two (0.5%) delivered within 7 days of the time a short cervix was identified. With a policy of giving ACS at the time an ultrasound shows a short cervix, 184 patients would have to be treated for each one who realizes a steroid benefit by delivering within 7 days.

Conclusion We conclude that unless future studies show that neonates benefit from ACS given more than 7 days before delivery, giving ACS to asymptomatic women solely because the cervix is short is not advised.

Keywords

antenatal corticosteroids - cervical length - premature birth
 

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