Efficacy of dexamethasone for lung maturity in preterm delivery in association with lamellar bodies count
Keywords:
Preterm delivery, dexamethasone, lamellar bodies, lung maturity
Abstract
Background Organ immaturities in preterm infants may result inperinatal death. One of the diseases is respiratory distress syndrome
(RDS) which is caused by lung immaturity. Dexamethasone is often
used to accelerate maturity of infant lungs.
Objective To determine the efficacy of dexamethasone on lung
maturity measured by lamellar bodies count.
Methods A quasi experimental study was done at Perinatology
Division, Department of Child Health, Medical School, Udayana
University, Sanglah Hospital, Denpasar. We recruited 72 subjects;
36 subjects were given four times intramuscular dexamethasone
5 mg every twelve hours before delivery. Thirty six subjects who
did not receive dexamethasone belonged to control group. Infants’
lungs maturity assessment was performed using lamellar bodies
count taken from amniontic fluid.
Results The gestational age ranged between 28 to 36 weeks, with
the mean gestational age in dexamethasone group was 32.2 (SD
1.76) weeks and that in control group was 31.7 (SD 2.65) weeks.
The efficacy of dexamethasone therapy on lung maturity was
significant with Fisher’s exact test P<0.0001, 95%CI 2.546;
11.173. Using multivariate logistic regression analysis, there was
significant correlation between dexamethasone and lung maturity
measured by lamellar bodies count [OR=239.39; P<0.0001,
95%CI 22.12;526.53].
Conclusion Administration of dexamethasone in pregnant
women during preterm delivery significantly improves lung
maturity measured by lamellar bodies count.
References
1. Hamid A. Penatalaksanaan bayi kurang bulan. In: Hamid
A, editor. Neonatologi I. Denpasar: Lab IKA FK UNUD;
1990. p. 25-7.
2. Iams JD. Obstetric Inertia: An obstacle to the prevention of
prematurity. Am J Obstet Gynecol 1998;256:796-9.
3. Levin LD. Hyaline membrane disease. In: Levin LD, Morris
CF, Moore CG, editors. A practical guide to Pediatric
Intensive care. 2 nd ed. Princeton: The CV Mosby Company;
1984. p. 222-31.
4. Overall CJ. Hyaline membrane disease. In: Behrman ER,
Vaughan CV, Nelson EW, editors. Nelson textbook of
pediatrics. 13 th ed. Philadelphia: WB Saunders Company;
1987. p. 394-8.
5. Haslam R. Neonatal respiratory distress. In: Marnoto W,
Widodo E, Kamarul I, editors. Penanganan gangguan napas
pada neonatus. Naskah Forum Ilmiah Tahunan ke V RSAB
Harapan Kita. Jakarta: FKUI; 1992. p. 25-31.
6. Karsono B, Wiknyosastro GH. Pemeriksaan surfaktan cairan
ketuban dan hubungannya sindrom distres pernafasan.
Presented at the 8 th Conference of Obstetric Gynecology,
1987, July 11-15, 1987; Semarang, Indonesia.
7. Narere AA. Kematian perinatal di RS Sanglah Denpasar
periode tahun 2000-2001. Diskriptif study. Denpasar: Bagian
Ilmu Kebidanan dan Penyakit Kandungan FK. UNUD; 2001.
p. 1 -8.
8. Satoh K, Sakata H, Nishuijima S. Assessment of fetal lung
maturity using newly developed immunological measurement
of fetal pulmonary surfactant apoprotein – A in amniotic
fluid. Cited 2002 October 15. Available from: URL: http://
scientific.sysmex.co.jp/spa/paper_e/214086.htm.
9. Albert MD, Morison JC. Glucocorticoids and fetal pulmonary
maturity. In: Rayburn WF, Zuspan FP, editors. Drug therapy in obstetric
and gynecology. 3 rd ed. Princeton: Mosby; 1992. p. 90-102.
10. Egerman RS, Mercer BM, Doss JL, Sibai BM. A randomized
controlled trial of oral and intramuscular dexamethasone in
the prevention of neonatal respiratory distress syndrome. Am
J Obstet Gynecol 1998;179:1120-3.
11. Well LR, Papile LA, Gardner MO, Hartenberger CR, Merker
L. Impact of antenatal corticosteroid therapy in very low birth
weight infant on chronic lung disease and other morbidities
of prematurity. J Perinatol 1999;19:578-81.
12. Amirulah A, Akib A. Penyakit membran hialin. In: Markum
A.H, Ismael S, Alatas H, Akib A, Firmansyah A, Sastroasmoro
S, editors. Buku ajar ilmu Kesehatan Anak Jilid I. Jakarta:
FKUI; 1991. p. 303-7.
13. Lubchenco LO. The preterm infant. In: Scaffer AJ, editor.
The high risk Infant. Philadelphia, London, Toronto: WB
Saunders; 1976. p. 125-48.
14. Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth
JC, Wenstrom KD. Williams’s Obstetrics. 21 st ed. New York:
Mc Graw-Hill; 2000. p. 690-718.
15. Atlanta Maternal-Fetal Medicine. Clinical discussional;
Abreast of pneumatic maturity: lamellar body count predicts
lung in good shape. 1996. Cited 2002 October 12. Available
from: URL: http://www.atlanta-mfm.com.
16. Cunningham FG. Hyaline membrane disease. In: Cunningham
FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom
KD, editors. Williams’s Obstetrics. 21 st ed. New York: Mc
Graw-Hill; 2000. p. 568-609.
17. Cunningham FG. The risk preterm infant. In: Cunningham
FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom
KD, editors. Williams’s Obstetrics. 21 st ed. New York: Mc
Graw-Hill; 2000. p. 16-29.
18. Leveno KJ. The prevention of neonatal respiratory distress
syndrome. In: Cunningham FG, Gant NF, Leveno KJ, Gilstrap
LC, Hauth JC, Wenstrom KD, editors. Williams’s Obstetrics.
21 st ed. New York: Mc Graw-Hill; 2000. p. 486-506.
19. Cunningham FG. The preterm pregnancy. In: Cunningham
FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom
KD, editors. Williams’s Obstetrics. 21 st ed. New York: Mc
Graw-Hill; 2000. p. 538-57.
20. Lab/SMF Obstetri dan Ginekologi FK UNUD/RSUP Sanglah
Denpasar. Standar diagnosis dan terapi. Denpasar: FK
UNUD; 2003. p. 12-20.
21. Roberts WE, Morrison JC. Pharmacologic induction of fetal
lung maturity. Clin Obstet Gynecol 1991;34:319-27.
22. Eriksen NL, Blanco JD. The role of corticosteroids
management in patients with preterm premature rupture of
the membranes. Am J Obstet Gynecol 1991;34:694-701.
23. Junara P. Antenatal corticosteroid therapy and fetal
behaviour: a randomized study. Presented at the 13 th National
Congress of Pediatrics, Bandung; July 4-8, 2005.
24. Henderson-Smart DJ, Duck-Chong CG. Fetal lung
maturation assessment after administration of glucocorticoid.
Med J Aus 1991;2:535-6.
25. Scottish Neonatal Consultants’ Collaborative Study Group.
Trends and variations in use of antenatal corticosteroids to
prevent neonatal respiratory distress syndrome: recommen-
dations for national and international comparative audit.
British J Obstet Gynaecol 1996;103:534-40.
26. Tarnow, Mordi W. Trends and variation in use of antenatal
corticosteroid to prevent neonatal respiratory distress
syndrome: recommendation for national and international
comparative audit. Br J Obstet Gynaecol 1996;103:534-40.
27. Sinclair JC. Meta-analysis of randomized controlled trials of
antenatal corticosteroid for the prevention of respiratory
distress. Am J Obstet Gynecol 1995;24:335-44.
A, editor. Neonatologi I. Denpasar: Lab IKA FK UNUD;
1990. p. 25-7.
2. Iams JD. Obstetric Inertia: An obstacle to the prevention of
prematurity. Am J Obstet Gynecol 1998;256:796-9.
3. Levin LD. Hyaline membrane disease. In: Levin LD, Morris
CF, Moore CG, editors. A practical guide to Pediatric
Intensive care. 2 nd ed. Princeton: The CV Mosby Company;
1984. p. 222-31.
4. Overall CJ. Hyaline membrane disease. In: Behrman ER,
Vaughan CV, Nelson EW, editors. Nelson textbook of
pediatrics. 13 th ed. Philadelphia: WB Saunders Company;
1987. p. 394-8.
5. Haslam R. Neonatal respiratory distress. In: Marnoto W,
Widodo E, Kamarul I, editors. Penanganan gangguan napas
pada neonatus. Naskah Forum Ilmiah Tahunan ke V RSAB
Harapan Kita. Jakarta: FKUI; 1992. p. 25-31.
6. Karsono B, Wiknyosastro GH. Pemeriksaan surfaktan cairan
ketuban dan hubungannya sindrom distres pernafasan.
Presented at the 8 th Conference of Obstetric Gynecology,
1987, July 11-15, 1987; Semarang, Indonesia.
7. Narere AA. Kematian perinatal di RS Sanglah Denpasar
periode tahun 2000-2001. Diskriptif study. Denpasar: Bagian
Ilmu Kebidanan dan Penyakit Kandungan FK. UNUD; 2001.
p. 1 -8.
8. Satoh K, Sakata H, Nishuijima S. Assessment of fetal lung
maturity using newly developed immunological measurement
of fetal pulmonary surfactant apoprotein – A in amniotic
fluid. Cited 2002 October 15. Available from: URL: http://
scientific.sysmex.co.jp/spa/paper_e/214086.htm.
9. Albert MD, Morison JC. Glucocorticoids and fetal pulmonary
maturity. In: Rayburn WF, Zuspan FP, editors. Drug therapy in obstetric
and gynecology. 3 rd ed. Princeton: Mosby; 1992. p. 90-102.
10. Egerman RS, Mercer BM, Doss JL, Sibai BM. A randomized
controlled trial of oral and intramuscular dexamethasone in
the prevention of neonatal respiratory distress syndrome. Am
J Obstet Gynecol 1998;179:1120-3.
11. Well LR, Papile LA, Gardner MO, Hartenberger CR, Merker
L. Impact of antenatal corticosteroid therapy in very low birth
weight infant on chronic lung disease and other morbidities
of prematurity. J Perinatol 1999;19:578-81.
12. Amirulah A, Akib A. Penyakit membran hialin. In: Markum
A.H, Ismael S, Alatas H, Akib A, Firmansyah A, Sastroasmoro
S, editors. Buku ajar ilmu Kesehatan Anak Jilid I. Jakarta:
FKUI; 1991. p. 303-7.
13. Lubchenco LO. The preterm infant. In: Scaffer AJ, editor.
The high risk Infant. Philadelphia, London, Toronto: WB
Saunders; 1976. p. 125-48.
14. Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth
JC, Wenstrom KD. Williams’s Obstetrics. 21 st ed. New York:
Mc Graw-Hill; 2000. p. 690-718.
15. Atlanta Maternal-Fetal Medicine. Clinical discussional;
Abreast of pneumatic maturity: lamellar body count predicts
lung in good shape. 1996. Cited 2002 October 12. Available
from: URL: http://www.atlanta-mfm.com.
16. Cunningham FG. Hyaline membrane disease. In: Cunningham
FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom
KD, editors. Williams’s Obstetrics. 21 st ed. New York: Mc
Graw-Hill; 2000. p. 568-609.
17. Cunningham FG. The risk preterm infant. In: Cunningham
FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom
KD, editors. Williams’s Obstetrics. 21 st ed. New York: Mc
Graw-Hill; 2000. p. 16-29.
18. Leveno KJ. The prevention of neonatal respiratory distress
syndrome. In: Cunningham FG, Gant NF, Leveno KJ, Gilstrap
LC, Hauth JC, Wenstrom KD, editors. Williams’s Obstetrics.
21 st ed. New York: Mc Graw-Hill; 2000. p. 486-506.
19. Cunningham FG. The preterm pregnancy. In: Cunningham
FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Wenstrom
KD, editors. Williams’s Obstetrics. 21 st ed. New York: Mc
Graw-Hill; 2000. p. 538-57.
20. Lab/SMF Obstetri dan Ginekologi FK UNUD/RSUP Sanglah
Denpasar. Standar diagnosis dan terapi. Denpasar: FK
UNUD; 2003. p. 12-20.
21. Roberts WE, Morrison JC. Pharmacologic induction of fetal
lung maturity. Clin Obstet Gynecol 1991;34:319-27.
22. Eriksen NL, Blanco JD. The role of corticosteroids
management in patients with preterm premature rupture of
the membranes. Am J Obstet Gynecol 1991;34:694-701.
23. Junara P. Antenatal corticosteroid therapy and fetal
behaviour: a randomized study. Presented at the 13 th National
Congress of Pediatrics, Bandung; July 4-8, 2005.
24. Henderson-Smart DJ, Duck-Chong CG. Fetal lung
maturation assessment after administration of glucocorticoid.
Med J Aus 1991;2:535-6.
25. Scottish Neonatal Consultants’ Collaborative Study Group.
Trends and variations in use of antenatal corticosteroids to
prevent neonatal respiratory distress syndrome: recommen-
dations for national and international comparative audit.
British J Obstet Gynaecol 1996;103:534-40.
26. Tarnow, Mordi W. Trends and variation in use of antenatal
corticosteroid to prevent neonatal respiratory distress
syndrome: recommendation for national and international
comparative audit. Br J Obstet Gynaecol 1996;103:534-40.
27. Sinclair JC. Meta-analysis of randomized controlled trials of
antenatal corticosteroid for the prevention of respiratory
distress. Am J Obstet Gynecol 1995;24:335-44.
Published
2007-07-01
How to Cite
1.
Sumiartini N, Santoso H, Retayasa W, Kardana M. Efficacy of dexamethasone for lung maturity in preterm delivery in association with lamellar bodies count. PI [Internet]. 1Jul.2007 [cited 20Apr.2024];47(3):115-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/356
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Received 2016-08-25
Accepted 2016-08-25
Published 2007-07-01
Accepted 2016-08-25
Published 2007-07-01
