Antenatal kortikosteroit uygulamalarındaki güncel gelişmeler

Yıl 2011, Cilt: 18 Sayı: 4, 144 - 149, 30.12.2011

Meltem Antalyalı Mekin Sezik

https://izlik.org/JA84RL22YW

Öz

Preterm doğumları engellemede genel önlemler ve tokolitik tedaviler çoğunlukla başarısız olmaktadır. Doğum öncesi anneye verilen deksametazon ve betametazon, fetal akciğer gelişimini hızlandırarak erken doğan bebeklerde respiratuvar distres sendromu sıklığını azaltmaktadır. Mevcut derlemede, antenatal kortikosteroit tedavisine dair en son gelişmeler tartışılmıştır. Yeni bulgular, antenatal kortikosteroit tedavisinin deksametazon yerine betametazon kullanılarak 26–36. gebelik haftaları arasında, tek veya en az 14 gün aralık ile iki kür uygulama şeklinde yapılmasına işaret etmektedir.

Anahtar Kelimeler

betametazon , kortikosteroit , preterm doðum , respiratuvar distres

Kaynakça

• Derbent A, Turhan A, Öztürk N. Erken doðum riski ve tahmini. Yeni Týp Dergisi 2009; 26: 139-144
• Bülbül A, Okan F, Þahin S, Nuhoðlu A. Düþük doðum aðýrlýklý erken doðmuþ bebeklerde erken dönem hastalýk ve ölüm oraný sonuçlarý. Türk Pediatri Arþivi 2008; 43: 94-98
• Þahin NH, Oskay Ü. Prematüre bebekleri yenidoðan yoðun bakým ünitesinde yatan ebeveynlerde ortaya çýkan stresörler. Çocuk Dergisi 2008; 8: 108-113
• Kream J, Mulay S, Fukushima DK, Solomon S. Determination of plasma dexamethasone in the mother and the newborn after administration of the hormone in a clinical trial. J Clin Endocrinol Metab. 1983; 56: 127-33
• Crowley P. Prophylactic corticosteroids for preterm birth. Cochrane Database Syst Rev 2000; 2: CD000065
• Mulder EJ, Derks JB, Visser GH. Antenatal corticosteroid therapy and fetal behavior: a randomised study of the effects of betamethasone and dexamethasone. Br J Obstet Gynaecol. 1997; 104: 1239-47
• Ballard PL, Granberg P, Ballard RA. Glucocorticoid levels in maternal and cord serum after prenatal betamethasone therapy to prevent respiratory distress syndrome. J Clin. Invest 1975; 56: 1548-54
• Anceschi MM, Palmerini CA, Codini M, Luzi P, Cosmi EV. Collagen and elastin in rabbit fetal lung: Ontogeny and effects of steroids. J Dev Physiol 1992; 18: 233- 6
• Rayburn WF, Christensen HD, Gonzalez CL. A placebo- controlled comparison between betamethasone and dexamethasone for fetal maturation: differences in neurobehavioral development of mice offspring. Am J Obstet Gynecol 1997; 176: 842-50
• Rayburn WF, Christensen HD, Gonzalez CL. A placebo-controlled comparison between betamethasone and dexamethasone for fetal maturation: differences in neurobehavioral development of mice offspring. Am J Obstet Gynecol 1997; 176: 842-51
• Brownfoot FC, Crowther CA, Middleton P. Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2008; 4: CD006764
• National Institutes of Health Consensus Development Conference Statement. Effect of corticosteroids for fetal maturation on perinatal outcomes. JAMA 1995; 273: 413-8
• Roberts D, Dalziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews. 2006, Issue 3. Art. No: CD004454. DOI: 10.1002/14651858
• Elimian A, Verma U, Beneck D, Cipriano R, Visintainer P, Tejani N. Histologic chorioamnionitis, antenatal steroids, and perinatal outcomes. Obstet Gynecol. 2000; 96: 333-6
• Murphy K, Aghajafari F. Single versus repetitive courses of corticosteroids: what do we know? Clin Obstet Gynecol 2003; 46: 161-73
• D'Amore A, Ahluwalia J, Cheema I, Prentice A, Kaptoge S, Kelsall W. The effect of antenatal corticosteroids on fetal growth, survival, and neurodevelopmental outcome in triplet pregnancies. Am J Perinatol. 2004; 21: 1-8
• Jobe AH, Wada N, Berry LM, Ikegami M, Ervin MG. Single and repetitive glucocorticoid exposures reduce fetal growth in sheep. Am J Obstet Gynecol. 1998; 178: 880-5
• Huang WL, Harper CG, Evans SF, Newnham JP, Dunlop SA. Repeated prenatal corticosteroid administration delays myelination of the corpus callosum in fetal sheep. Int J Dev Neurosci. 2001; 19: 415-25
• National Institutes of Health Consensus Development Panel: Antenatal corticosteroids revisited: repeat courses-National Institutes of Health Consensus Development Conference Statement, August 17-18, 2000. Obstet Gynecol. 2001; 98: 144-50
• Guinn DA, Atkinson MW, Sullivan L, et al. Single vs weekly courses of antenatal corticosteroids for women at risk of preterm delivery: a randomized controlled trial. JAMA. 2001; 286: 1581-7
• Garite TJ, Kurtzman J, Maurel K, Clark R; Obstetrix Collaborative Research Network. Impact of a 'rescue course' of antenatal corticosteroids: a multicenter randomized placebo-controlled trial. Am J Obstet Gynecol. 2009; 200: 248.e1-9
• McEvoy C, Schilling D, Peters D, Tillotson C, Spitale P, Wallen L, Segel S,et al. Respiratory compliance in preterm infants after a single rescue course of antenatal steroids: a randomized controlled trial. Am J Obstet Gynecol. 2010; 202 :544.e1-9.
• Ballard PL, Ballard RA. Scientific basis and therapeutic regimens for use of antenatal glucocorticoids. Int J Gynaecol Obstet.1996; 52: 326
• Stutchfield P, Whitaker R, Russell I; Antenatal Steroids for Term Elective Caesarean Section (ASTECS) Research Team. Antenatal betamethasone and incidence of neonatal respiratory distress after elective caesarean section: pragmatic randomised trial. BMJ 2005; 331: 662-7
• Dimitriou G, Fouzas S, Georgakis V, Vervenioti A, Papadopoulos VG, Decavalas
• G, et al. Determinants of morbidity in late preterm infants. Early Hum Dev. 2010; 86: 587-91
• Mulder EJ, Derks JB, Visser GH. Antenatal corticosteroid therapy and fetal behavior: a randomised study of the effects of betamethasone and dexamethasone. BJOG. 1997; 104: 1239-47
• Kelly MK, Schneider EP, Petrikovsky BM, Lesser ML. Effect of antenatal steroid administration on the fetal biophysical profile. J Clin Ultrasound. 2000; 28: 224- 6
• O’Shea TM, Doyle LW. Perinatal glucocorticoid therapy and neurodevelopmental outcome: an epidemiologic perspective. Semin Neonatol. 2001; 6: 293-307
• Dessens AB, Haas HS, Koppe JG. Twenty-year follow- up of antenatal corticosteroid treatment. Pediatrics. 2000; 105: E77
• Vidaeff AC, Mastrobattista JM. Controversies in the use of antenatal steroids for fetal maturation. Semin Perinatol. 2001; 25: 385-96
• Elliman D, Browning MCK, Forsyth CC. Adrenal axis supression due to maternal corticosteroid theraphy. Pediatr Res. 1981; 15: 1187
• McKenna DS, Wittber GM, Nagaraja HN, Samuels P. The effects of repeat doses of antenatal corticosteroids on maternal adrenal function. Am J Obstet Gynecol. 2000; 183: 669-73
• Bradley BS, Kumar SP, Mehta PN, Ezhuthachan SG. Neonatal cushingoid syndrome resulting from serial courses of antenatal betamethasone. Obstet Gynecol. 1994; 83: 869-72.
• Terrone DA, Smith LG Jr, Wolf EJ, Uzbay LA, Sun S, Miller RC. Neonatal effects and serum cortisol levels after multiple courses of maternal corticosteroids. Obstet Gynecol. 1997; 90: 819-23
• Terrone DA, Rinehart BK, Rhodes PG, Roberts WE, Miller RC, Martin JN Jr. Multiple courses of betamethasone to enhance fetal lung maturation do not suppress neonatal adrenal response. Am J Obstet Gynecol. 1999; 180: 1349-53
• Ogueh O, Khastgir G, Studd JW, Jones J, Alaghband- Zadeh J, Johnson MR. Antenatal corticosteroid therapy and risk of osteoporosis. BJOG. 1998; 105: 551-5
• Rotmensch S, Vishne TH, Celentano C, Dan M, Ben- Rafael Z. Maternal infectious morbidity following multiple courses of betamethasone. J Infect. 1999; 39: 49-54
• Yunis KA, Bitar FF, Hayek P, Mroueh SM, Mikati M. Transient hypertrophic cardiomyopathy in the newborn following multiple doses of antenatal corticosteroids. Am J Perinatol. 1999; 16: 17-21
• Wood CE, Cheung CY, Brace RA. Fetal heart rate, arterial pressure, and blood volume responses to cortisol infusion. Am J Physiol. 1987; 253: R904-9
• Azancot-Benisty A, Benifla JL, Matias A, De Crépy A, Madelenat P. Constriction of the fetal ductus arteriosus during prenatal betamethasone therapy. Obstet Gynecol. 1995; 85: 874-6.