Abstract
Background: Administration of antenatal steroids improves neonatal outcome and is common practice in imminent preterm delivery. Available guidelines delineate chorioamnionitis as a contraindication for antenatal steroids. However, observational evidence suggests antenatal steroids to be safe and effective in chorioamnionitis. We explored perinatologists' opinions on this issue.
Design/Methods: A nationwide email-based survey consisting of four multiple choice questions was performed among all Dutch perinatologists (n=116).
Results: Fifty-nine perinatologists (51%) sent back a response. In a pregnant woman of 30 weeks gestation with preterm labour and clinical CA, only a minority would actively promote delivery by giving stimulants (9%) or performing a C-section (9%). Fifty-four percent would give antenatal steroids, even though many feel there is a lack of evidence on their efficacy (86%) and safety (50%) in CA. Giving steroids to a mother with clinical CA is considered potentially harmful to either the baby, the mother, or both by 38%. Finally, 64% of the respondents would favour a clinical trial on the efficacy and safety of antenatal steroids in preterm labour with clinical CA, although another 26% fear the potential risks for mother and child.
Conclusion: There is great diversity in perinatologists' opinions on the safety and efficacy of antenatal steroids in preterm labour with clinical CA. The majority feel there is lack of evidence on the subject and favour an RCT addressing the issue.
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Lievense, S., Kramer, B., Nijhuis, J. et al. 1241 Antenatal Steroids in Chorioamnionitis: Friend or Foe? a Nationwide Survey Among Perinatologists. Pediatr Res 68 (Suppl 1), 615 (2010). https://doi.org/10.1203/00006450-201011001-01241
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DOI: https://doi.org/10.1203/00006450-201011001-01241