Podcast
Questions and Answers
What should be done for women with multiple pregnancies who are at risk of preterm birth?
What should be done for women with multiple pregnancies who are at risk of preterm birth?
- Consider the use of adjunct prediction tests exclusively
- Do not provide any corticosteroids under any circumstances
- Only provide repeat doses of corticosteroids
- Administer a single course of corticosteroids as per guidelines (correct)
In which situation should repeat doses of corticosteroids not be administered to women with multiple pregnancies?
In which situation should repeat doses of corticosteroids not be administered to women with multiple pregnancies?
- When preterm birth is imminent within 24 hours
- When there is a risk of preterm birth present
- If there is no identified risk of preterm birth (correct)
- If a single course has already been given
What adjunct prediction tests are suggested for identifying imminent delivery in women with spontaneous preterm labor?
What adjunct prediction tests are suggested for identifying imminent delivery in women with spontaneous preterm labor?
- Routine ultrasound scans every week
- Assessing uterine contractions frequency
- Maternal blood pressure monitoring
- Fetal fibronectin or transvaginal cervical length measurements (correct)
What is recommended for women at gestational age 23+0 to 23+6 weeks when preterm birth is expected within the next seven days?
What is recommended for women at gestational age 23+0 to 23+6 weeks when preterm birth is expected within the next seven days?
Which of the following is NOT a guideline for administering corticosteroids to women with multiple pregnancies?
Which of the following is NOT a guideline for administering corticosteroids to women with multiple pregnancies?
Why should a single course of corticosteroids be considered at a gestational age of 23+0 to 23+6 weeks?
Why should a single course of corticosteroids be considered at a gestational age of 23+0 to 23+6 weeks?
What is the recommended approach for women at risk of early preterm birth regarding corticosteroids?
What is the recommended approach for women at risk of early preterm birth regarding corticosteroids?
Which corticosteroid is typically recommended for a two dose course?
Which corticosteroid is typically recommended for a two dose course?
In which scenario should repeat antenatal corticosteroids be considered?
In which scenario should repeat antenatal corticosteroids be considered?
What is a key consideration when determining repeat corticosteroid dosing?
What is a key consideration when determining repeat corticosteroid dosing?
What should be considered when selecting corticosteroids for repeat administration?
What should be considered when selecting corticosteroids for repeat administration?
Which of the following is NOT a consideration for antenatal corticosteroid use?
Which of the following is NOT a consideration for antenatal corticosteroid use?
What is the potential impact of antenatal corticosteroids on neonatal outcomes?
What is the potential impact of antenatal corticosteroids on neonatal outcomes?
What is a common misconception about the use of repeat antenatal corticosteroids?
What is a common misconception about the use of repeat antenatal corticosteroids?
What is the primary purpose of administering antenatal corticosteroids to women prior to birth?
What is the primary purpose of administering antenatal corticosteroids to women prior to birth?
At what gestational age are antenatal corticosteroids considered standard care for women at high risk of preterm birth?
At what gestational age are antenatal corticosteroids considered standard care for women at high risk of preterm birth?
What is the recommended administration method for antenatal corticosteroids?
What is the recommended administration method for antenatal corticosteroids?
What is the indication for a repeat dose of corticosteroids?
What is the indication for a repeat dose of corticosteroids?
Which major morbidity can antenatal corticosteroids help reduce in preterm infants?
Which major morbidity can antenatal corticosteroids help reduce in preterm infants?
What is a potential benefit of administering repeat doses of corticosteroids according to the evidence?
What is a potential benefit of administering repeat doses of corticosteroids according to the evidence?
What critical factor regarding corticosteroids remains uncertain according to the guidelines?
What critical factor regarding corticosteroids remains uncertain according to the guidelines?
What evidence is noted about follow-up studies of children who received repeat corticosteroids?
What evidence is noted about follow-up studies of children who received repeat corticosteroids?
Study Notes
Purpose of Policy
- Recommendations provided for the use of antenatal corticosteroids to enhance neonatal outcomes.
Guideline Management Principles and Goals
- Antenatal steroids recommended for women at high risk of birth before 35 weeks gestation.
- A single repeat dose may be given if the risk of preterm birth persists, up to 32 weeks and 6 days.
Background
- Administration of intramuscular corticosteroids significantly lowers mortality and morbidity in very and moderately preterm infants.
- Benefits include reduced incidence of respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis.
- Standard care established for women at high risk of delivering before 35 weeks gestation since 1990.
- Meta-analyses show neonatal advantage from repeat doses of corticosteroids for women at ongoing risk of preterm birth (7 to 14 days post-initial course) without adverse effects noted in long-term follow-up.
Definitions
- Clarification of terms related to antenatal corticosteroid use.
Summary of Guidelines
- Detailed protocols for two-dose courses of antenatal corticosteroids in women at risk of early preterm birth.
Multiple Pregnancies
- Single and repeat corticosteroid doses should follow general guidelines for women at risk of preterm birth.
- Avoid use in women with multiple pregnancies without other preterm risk factors.
- Utilize prediction tests (like fetal fibronectin or cervical length assessment) to identify those likely to deliver imminently.
Specific Gestational Age Recommendations
- At gestational age 23 weeks and 0 days to 23 weeks and 6 days, consider a single corticosteroid course if preterm birth is expected within the week, following a thorough review and planning for active intervention.
Further Actions and Documentation
- Reference associated guidelines for managing threatened and active preterm labor (PTL).
- Include flowcharts for visual guidance on corticosteroid administration.
Additional Considerations
- Various indications and best practice points regarding corticosteroid use in antenatal care.
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Description
Test your knowledge on guidelines for pregnant women at risk of early preterm birth. Learn about the recommended procedures and best practices.
