[Stimulation of fetal lung maturation with dexamethasone in unexpected premature labor].
BACKGROUND
Preterm labour is most common complication of second half of pregnancy, incidence is 7 to 10% of all delivers. One of most important causes of increased mortality and morbidity of neonates is respiratory distress syndrome. Numerous studies prove that corticosteroids given antenatal to mother decrease the incidence of preterm delivered neonates. AIM OF THIS STUDY IS: To determined influence of dexamethasone given prepartal on maturation of neonatal lungs in correlation with gestational age.


METHODS
This study include 150 pregnant women which delivered before 37 week of gestation. They are divide in three groups: two experimental and one control group. Group E1 consists of the pregnant women which received dexamethasone for five days in a single dose of 12 mg. Group E2 consists of the pregnant women which received dexamethasone less then five days, in a single dose of 12 mg. In the control group consists of the pregnant women which did not received dexamethasone. In this work we used gestational age in the moment of delivery. State of neonate is determined on the base of presence of clinical signs of respiratory distress syndrome after birth. Statistical method used in this work was test of proportion.


RESULTS
In this work we find that there is a less number of neonates who has respiratory distress syndrome in group consists of the pregnant women which received dexamethasone for five days, 5 (10%). In group consists of the pregnant women which received dexamethasone less then five days, number of neonates with respiratory distress syndrome was 12 (24%). The number of neonates with respiratory distress syndrome in control group was 21 (42%). The value of test of proportion: K/E1 (the pregnant women received dexamethasone for five days)-z = 1.95, p < 0.05; K/E2 (pregnant women received dexamethasone less than five days)-z = 3.92, p < 0.05. In all three groups largest number of neonates with respiratory distress syndrome was between 31-34 week of gestation. Highest mortality of neonate with respiratory distress syndrome was in control group, 7 (14%), than in group consists of the pregnant women received dexamethasone lass then five days, 4 (8%). In group consist pregnant women received dexamethasone for five days, there were not cases of mortality caused by respiratory distress syndrome. The value of test of proportion was z = 2.85 (p < 0.05), between control group and group consists of the pregnant women received dexamethasone for five days.


CONCLUSIONS
Dexamethasone accelerates maturation of fetal lungs, decrease number of neonates with respiratory distress syndrome and improves survival in preterm delivered neonates. Optimal gestational age for use of dexamethasone therapy is 31 to 34 weeks of gestation.
Grgić
Gordana
G
Ginekolosko-akuserska klinika, Univerzitetsko-klinicki centar Tuzla.
Fatusić
Zlatan
Z
Bogdanović
Gordana
G
D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005325:Fetal Organ Maturity / Q000187:drug effects*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000196:embryology*; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control*
D005938:Glucocorticoids; D003907:Dexamethasone