Revista Biomédica Revisada Por Pares
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Palabras clave: caesarean section, elective surgical procedures, term birth, neonatal respiratory distress syndrome, corticosteroids, betamethasone
INTRODUCTION
Neonatal respiratory distress syndrome is closely related to gestational age and mode of birth. Lowest gestational ages and caesarean section are associated with higher risk of developing respiratory distress syndrome. The efficacy of antenatal corticosteroids is well established in the induction of lung maturation in premature births. Its use could be a beneficial intervention in term fetuses that will be born by elective caesarean section.
OBJECTIVE
To find the best evidence available to determine whether the use of antenatal corticosteroids reduces the incidence of respiratory distress syndrome in term babies born by elective caesarean section.
METHODOLOGY
We searched the available medical literature in different databases: PubMed, LILACS, UpToDate, Trip database, Scielo and Cochrane. We considered controlled, randomized therapeutic studies, performed on humans, in which the intervention included corticosteroids as a treatment in elective term cesareans.
RESULTS
We selected two studies. In both, the intervention was two doses of 12 mg of dexamethasone before the caesarean section. The primary objective in both studies was to analyze the incidence of respiratory distress syndrome and the admission of the newborn into intensive care units. In both studies, there was less incidence of neonatal respiratory distress syndrome, with statistically significant results.
CONCLUSIONS
We concluded that the use of corticosteroids in elective term caesarean section reduces the incidence of neonatal respiratory distress syndrome and the admission into intensive care units. However, we evidenced certain weaknesses that could modify the internal validity of both studies, so it is necessary to develop new studies that could support these findings in order to modify clinical protocols in term elective caesarean sections.
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INTRODUCTION
Neonatal respiratory distress syndrome is closely related to gestational age and mode of birth. Lowest gestational ages and caesarean section are associated with higher risk of developing respiratory distress syndrome. The efficacy of antenatal corticosteroids is well established in the induction of lung maturation in premature births. Its use could be a beneficial intervention in term fetuses that will be born by elective caesarean section.
OBJECTIVE
To find the best evidence available to determine whether the use of antenatal corticosteroids reduces the incidence of respiratory distress syndrome in term babies born by elective caesarean section.
METHODOLOGY
We searched the available medical literature in different databases: PubMed, LILACS, UpToDate, Trip database, Scielo and Cochrane. We considered controlled, randomized therapeutic studies, performed on humans, in which the intervention included corticosteroids as a treatment in elective term cesareans.
RESULTS
We selected two studies. In both, the intervention was two doses of 12 mg of dexamethasone before the caesarean section. The primary objective in both studies was to analyze the incidence of respiratory distress syndrome and the admission of the newborn into intensive care units. In both studies, there was less incidence of neonatal respiratory distress syndrome, with statistically significant results.
CONCLUSIONS
We concluded that the use of corticosteroids in elective term caesarean section reduces the incidence of neonatal respiratory distress syndrome and the admission into intensive care units. However, we evidenced certain weaknesses that could modify the internal validity of both studies, so it is necessary to develop new studies that could support these findings in order to modify clinical protocols in term elective caesarean sections.
Autores:
Felipe Petour Gazitúa[1], Javiera Pérez Velásquez[1]
Citación: Petour Gazitúa F, Pérez Velásquez J. Do antenatal corticosteroids in term elective cesarean sections reduce neonatal respiratory morbidity?. Medwave 2015 Oct;15(9):e6280 doi: 10.5867/medwave.2015.09.6280
Fecha de envío: 7/7/2015
Fecha de aceptación: 28/9/2015
Fecha de publicación: 7/10/2015
Origen: no solicitado
Tipo de revisión: con revisión por dos pares revisores externos, a doble ciego
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Nombre/name: eduardo ivan ojeda
Fecha/date: 2015-10-16 13:31:18
Comentario/comment:
Interesante, pero siendo que la taquipnea transitoria suele ser leve y transitoria, obviamente; y que el SDR en los embarazos a término no son muy frecuentes, valdrÃa la pena someter a las gestantes que van por cesárea a la administración de corticoides? Es decir, a todas?
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