Does Antenatal Dexamethasone before Full Term Planned Cesarean Section Affect the Incidence or Severity of neonatal Jaundice? A Randomized Controlled Trial

Document Type : Original Article

Author

1 MD OB GYN, ASSITANT . PROFESSOR OBS & GYN, Faculty of Medicine, MANSOURA UNIVERSITY

2 MD OBS &.GYN,faculty of medicine , Al Azhar University, Assistant Consultant at Al Sahil Teaching Hospital,General Organization of Teaching Hospitals and Institutes. EGYPT

Abstract

Objectives: Toevaluate the effectiveness of antenatal dexametha- sone before elective caesarean section at 37-39 weeks of gestation in reducing incidence and/or severity of neonatal jaundice.Patients and.
Methods: A randomized controlled study was done in the Depart- ment of Obstetrics and Gynecology, Mansoura University Hospital. The study group received three doses of intramuscular dexameth- asone 8 mg ampoules at 8-hourly interval over 24 hours ended 48 hours before time of elective CS. Control group received the usual management without dexamethasone. Neonates were followed up and those who presented with neonatal jaundice within the first 72 hour of delivery (physiologic jaundice) the level of total bilirubin was measured.
Results: The study included 200 cases. Hundred cases (50 %), re- ceived single course of antenatal dexamethasone and 100 control cases (50%). the incidence of neonatal jaundice (group 1 was 34% and group 2 was 38%) and the mean level of bilirubin in neonates who develop jaundice (group1 was 11.52±0.56 mg/dl) and (group  2 was 13.08±0.72 mg/dl). No significant difference were found between the intervention and the control groups regarding the inci- dence of jaundice (p=0.56) while there was a significant difference in bilirubin level in neonates who developed jaundice (P<0.001).
Conclusion: Administration of antenatal dexamethasone before elective CS at 37-39 gestational weeks was associated with reduced incidence of neonatal jaundice and lower level of bilirubin in cases that developed jaundice.

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