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Antenatal Corticosteroid Therapy Update

Obstet Gynecol; ePub 2017 Aug; El-Sayed, et al

The American College of Obstetricians and Gynecologists (ACOG) has issued an interim update on antenatal corticosteroid therapy administration for fetal maturation. The updated committee opinion stresses that among specific populations, antenatal corticosteroids should be administered when a woman is at risk of preterm delivery within 7 days. The updated ACOG recommendation includes the following:

  • A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation who are at risk of preterm delivery within 7 days, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family’s decision regarding resuscitation, irrespective of membrane rupture status and regardless of fetal number.
  • A single repeat course of antenatal corticosteroids should be considered in women who are less than 34 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, and whose prior course of antenatal corticosteroids was administered more than 14 days previously. Rescue course corticosteroids could be provided as early as 7 days from the prior dose, if indicated by the clinical scenario.

Citation:

Antenatal corticosteroid therapy for fetal maturation. Committee Opinion No. 713. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017;130:e102–9.