1. What Are Corticosteroid Injections for Fetal Lung Maturity?
Two drugs that promote early lung development in fetuses are Betamethasone and Dexamethasone. These are corticosteroid medications, which helps accelerate lung maturation in fetuses.
Corticosteroid injections for fetal lung maturity work through the following specific mechanism:
- After administering corticosteroid injections to the pregnant woman, the medication enters the fetus via the bloodstream and acts on the lungs.
- Supports the transformation of lung cells from type I alveolar cells to type II alveolar cells.
- Promotes the synthesis and release of more surfactant into the alveoli, reducing the surface tension of the alveolar fluid layer and counteracting the lung's elastic forces.
- Helps increase lung volume and reduce the amount of fluid in the lungs.
- After receiving corticosteroid injections, pregnant women often experience mild hyperglycemia for about 5 days. Therefore, it is recommended to screen for gestational diabetes before the injection to avoid complications. If the pregnant woman has gestational diabetes, she should stay in the hospital for monitoring and treatment after the injection.
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2. Effects of Corticosteroid Injections for Fetal Lung Maturity
For preterm infants born between 28-34 weeks, several internal organs are not yet fully developed, particularly the lungs. Preterm infants often face numerous health issues such as a weakened immune system, digestive disorders, low blood pressure, blood disorders like anemia, jaundice, sepsis, and especially severe respiratory problems.
To minimize dangerous respiratory complications, doctors often prescribe corticosteroid injections to pregnant women showing signs of preterm labor or at risk of preterm birth.
Generally, these injections help accelerate the development of the fetus's lungs to prevent respiratory distress complications in preterm infants.
3. When Should Corticosteroid Injections Be Administered?
Every pregnant woman hopes for their child to develop fully and comprehensively before birth. However, this medication should not be overused to stimulate lung development in the fetus. Corticosteroid injections should only be administered under a doctor’s recommendation for pregnant women at risk of preterm labor. So, when should corticosteroid injections be administered to maximize their effectiveness?
For pregnant women diagnosed with a risk of preterm labor, the recommended time to administer this medication is between the 24th and 34th weeks of pregnancy, especially if there is a risk of preterm birth within the next 7 days. Note that after the 34th week, corticosteroid injections are no longer significantly effective, so it is unnecessary to administer them to avoid wastage and unwanted side effects.
Dosage for Corticosteroid Injections:
- Betamethasone 12mg (Diprospan (5+2)mg): Intramuscular injection, 2 doses, 24 hours apart.
- Dexamethasone 6mg: Intramuscular injection, 4 doses, 12 hours apart.
4. Unwanted Side Effects of Corticosteroid Injections
Administering corticosteroid injections for fetuses at risk of preterm birth is essential to prevent respiratory complications. However, these medications may also cause some side effects, such as:
- The medication belongs to Category C, meaning it has potential side effects according to the U.S. Food and Drug Administration (FDA). Therefore, pregnant women must use it strictly as prescribed by the doctor and avoid overdosing or underdosing.
- Corticosteroid injections often increase the risk of infections in the mother after delivery.
- Causes elevated blood sugar for up to 5 days, requiring close monitoring to avoid gestational diabetes, which can lead to severe complications for both the mother and baby.
- After the injection, the fetus may exhibit reduced movement, and there is a risk of developing attention-deficit disorders in children after birth.
- After the injection, infants may experience slower weight gain, reduced head circumference, and early ossification of bone cartilage or premature skull suture closure.
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