Overview
Introduction
Antenatal corticosteroids, betamethasone and dexamethasone, are given to a pregnant client at risk for preterm birth to accelerate fetal lung maturity and reduce the severity of...
Antenatal corticosteroids, betamethasone and dexamethasone, are given to a pregnant client at risk for preterm birth to accelerate fetal lung maturity and reduce the severity of neonatal respiratory distress syndrome. They work by stimulating fetal surfactant production, and they also lower the incidence of intraventricular hemorrhage and necrotizing enterocolitis in the preterm neonate. Because the benefit depends on timing, the nurse must understand both when the drug is indicated and how to monitor the client while it takes effect. The standard indication is a single course between 24 weeks and 33 weeks and 6 days when preterm delivery is expected within 7 days. A single course may also be considered from 34 weeks through 36 weeks and 6 days when late-preterm delivery is anticipated within 7 days and no previous course has been administered. At 22 weeks through 22 weeks and 6 days, treatment may be considered when neonatal resuscitation is planned after thorough counseling; antenatal corticosteroids are not recommended before 20 weeks. Betamethasone is given as two deep intramuscular doses 24 hours apart; dexamethasone follows a four-dose intramuscular schedule...