Abstract
OBJECTIVE: To assess the effects of prophylactic antenatal dexamethasone
administration in reducing the neonatal respiratory morbidity at term after
elective lower segment caesarean section (LSCS).
METHODS: This open label randomized-controlled trial was conducted in
Department of Obstetrics and Gynaecology, Kahuta Research Laboratories
(KRL) Hospital, Islamabad from September 2017 to February 2018. Patients
with singleton pregnancy and non-anomalous fetus between gestational age of
0 6
37+ and 38+ , planned to be delivered by elective LSCS were randomized
through block-randomization method into interventional group (A): who
received dexamethasone and control group (B): who did not receive
prophylactic dexamethasone. Main outcomes of the study included Apgarscore at one & ve minutes, admission to neonatal intensive care unit (NICU)
due to transient tachypnea of newborn (TTN) and respiratory distress
syndrome (RDS). Data was analyzed by SPSS version 23.
RESULTS: A total of 304 women were randomized and equally assigned to
interventional and control group. In group-A, 2 neonates developed RDS as
compared to one neonate in group-B (p=0.391). Mean age of patients in group
A and B was 30.48±4.18 years and 29.38±4.57 years respectively. Fiveminutes Apgar score was 8.91±0.290 in group A & 8.87±0.393 in group B
(p=0.320). TTN developed in four neonates in group-A while one neonate in
group-B (p=0.176). Eighteen (11.8%) cases in group A & 12(7.9%) cases in
group B were admitted in NICU (p=0.249).
CONCLUSION: Prophylactic dexamethasone administration in term LSCS
after 37 weeks of gestational age has no signicant effects on reducing the
incidence of RDS, TTN and neonatal admission to NICU.
