Dexamethasone before Elective Caesarean Section at Term in Reducing Respiratory Distress Syndrome
DOI:
https://doi.org/10.70749/ijbr.v3i7.2322Keywords:
Dexamethasone, Elective caesarean delivery, Respiratory distress syndrome, Neonatal outcomeAbstract
Background: Neonatal respiratory distress syndrome is a common cause of neonatal morbidity following elective term caesarean section. It has been demonstrated that antenatal use of corticosteroids reduces neonatal respiratory distress syndrome incidence but such a benefit has not been determined at or before term caesarean section. Various studies have investigated dexamethasone as a potential prophylactic drug against neonatal respiratory distress. Objective: To compare the efficacy of dexamethasone and without dexamethasone before elective caesarean section at term in reducing respiratory distress syndrome. Study Design: Randomized controlled trial. Duration and Place of Study: The study was carried out from December 2024 to May 2025 in the Department of Obstetrics and Gynecology, Rawal Institute of Health Sciences, Islamabad. Methodology: A total of 550 women aged 18 to 40 years with singleton pregnancies beyond 36 weeks and scheduled for elective caesarean delivery were included. Participants were randomly allocated into two groups: Group A received two intramuscular doses of 12 milligrams dexamethasone at a 12-hour interval, completed 48 hours prior to surgery, while Group B received no steroid. All procedures were performed under spinal anesthesia with neonatal assessment by a specialist. Respiratory distress syndrome was defined by Downe’s score between three and six with an oxygen requirement less than 0.6, together with recurrent apneic episodes greater than two within twelve hours without resuscitation. Results: Neonatal efficacy was observed in 97.8 percent of the dexamethasone group compared with 89.8 percent in the control group (p<0.001). Subgroup analysis showed superior outcomes with dexamethasone in women with gestational age beyond thirty-nine weeks, parity greater than three, and previous history of neonatal respiratory distress syndrome. Conclusion: Dexamethasone given prior to elective caesarean delivery at term significantly reduces the occurrence of neonatal respiratory distress syndrome and may be recommended as prophylactic therapy.
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