STEROID MEDICATION FOR THE BABY'S LUNG DEVELOPMENT

The preterm labor or preterm birth threat is used to refer to situations between 20 and 37 weeks of gestation when the possibility of preterm birth is considered. Since the baby is not fully developed in terms of some organs and functions between these weeks, some precautions should be taken against a possible birth. Otherwise, when the baby is born, it may face various risks such as respiratory distress, need for intensive care, and infection. In this article, antenatal corticosteroid application to prevent respiratory distress after delivery will be discussed in infants at risk of preterm delivery.
Lung development of the baby in the womb:
In the womb, the baby's lung development begins especially around the 26th week. This week, alveoli develop in the lungs and surfactant production begins. Surfactant is the most important substance in the functioning and respiration of the lungs, and therefore it is also given as a medicine to newborn babies with respiratory distress. The lung development of the baby reaches quite good levels around the 34th week, and therefore lung enhancing drug treatments are applied up to this week. Of course, it cannot be said that the lungs of all babies developed completely at 34 weeks and babies born after 34 weeks will never have respiratory distress. Respiratory and other system problems are also rarely seen in babies born after 34th week. After the 34th week, antenatal steroids, lung development, etc. There are some researches as to whether it can be applied for reasons. There is no common consensus on this issue yet.
Corticosteroid drugs:
These drugs are divided into two as betamethasone and dexamethasone. Today, it is more widely used betamatazon. These drugs reduce the risk of various pathologies such as necrotizing enterocolitis, periventricular leukomalacia, intraventricular hemorrhage, especially by preventing the baby's lung development by giving birth to respiratory distress (respiratory distress syndrome, RDS). The reason why betamethasone is preferred more is that the negative effects of dexamethasone on some of the baby's neurological and behavioral functions are observed in some studies.
How are corticosteroid drugs applied?
The widely accepted use of betamethasone today is to use 24 mg intramuscularly, 12 mg twice every 24 hours, in pregnant women with a risk of preterm labor (between 24-34 weeks of gestation). It is also used in twin pregnancies.
(Intramuscular: injection (needle) applied to the hip intramuscularly)
Dexamethasone is administered 6 mg four times with a 12-hour interval, a total of 24 mg intramuscularly.
The application of these drugs is not made to the baby, but to the mother. The drug given to the mother by injection from the hip into the muscle passes to the baby through the placenta and acts on the baby.
Benefits of corticosteroid medication:
- The risk of respiratory distress syndrome (RDS, respiratory distress) in the baby decreases after delivery. The need for oxygen and respiratory support of the newborn is reduced. Cortocosteroid drugs do this by increasing the surfactant, which is a very important substance in terms of lung function, and by increasing the lung volume and compliance.
- Intraventricles hemorrhage (bleeding into the ventricular spaces in the brain) decreases.
- Periventricular leukomalacia decreases. (A pathology characterized by degeneration in the brain)
- The risk of necrotizing enterocolitis (impaired blood supply in the intestines) is reduced.
- Neonatal mortality decreases. (Death in newborn period)


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