[Prenatal corticosteroids. Use and attitudes of the gynecology-obstetrics medical staff].
OBJECTIVE
1. To evaluate the frequency of use of antenatal corticosteroids (AC) and the reasons for withholding them. 2. To estimate the knowledge and attitudes, regarding AC, from obstetricians, in a large Women and Babies Hospital.


METHODS
Through a prospective, observational and transversal study we evaluated: 1. The frequency of use of AC in pregnant with preterm labor (PL) and in mothers of preterm infants (P1). When AC were not given, the reasons were recorded. 2. With an anonymous inquiry we assessed the knowledge and attitude of obstetricians regarding AC, exploring different concepts such as usefulness, frequency of use, indications, risks and contraindications. Descriptive statistics was used.


RESULTS
We studied 364 patients (240 mothers of Pl and 124 pregnant women). The mean gestational age (GA) was 28.9 + 2.4 weeks. The AC were used only in 136 out of 364 (37.4%) women, and diminished to 30.9% (102/330), if are excluded 34 patients who did not receive AC because imminent delivery. Another reasons for not using AC were irregular uterine activity (18.9%), prolonged rupture of membranes without chorioamnioitis (11.4%), and GA lower than 27 weeks (11.4%) and toxemia (9.6%). Only in 43 out of 136 patients (31.6%) who were on tocolytic drugs, received AC. The schedule and doses were correct. According to the inquiry, 48/68 (0.71) of obstetricians considered AC as definitively useful, although only 22/68 (0.32) as very effective. The knowledge level was acceptable, except in signaling with precision the neonatal problems that could be prevented, as well as the lowest gestational age for use the AC.


CONCLUSIONS
We considered the use of AC in our institution as suboptimal. We found that the reasons for not using them were not valid in most cases. Physician's attitudes to AC are positive but it is not reflected on their clinical practice. It is necessary a strong promotion of the usefulness of the AC for the preterm infant.
Vargas-Origel
A
A
Hopital de Gineco-Pediatría No. 48, Centro Médico Nacional León, Gto.
León Ramírez
D
D
Zamora-Orozco
J
J
Vargas-Nieto
M A
MA
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006176:Gynecology; D006801:Humans; D009774:Obstetrics; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011295:Prenatal Care; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D000305:Adrenal Cortex Hormones