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Threatened Premature Labour

I am 30, a first-time mum and am 32 weeks pregnant. I had bleeding and labour pains a few days ago and was admitted to hospital. The bleeding and contractions have since subsided after medications. I was also given a steroid injection. What is it for and does it carry any risk to the baby?

A. From your description, you may have had a threatened premature labour. The steroid injection you received is probably the corticosteroids.

Babies born premature are at risk of having breathing difficulties and other serious health problems at birth. The steroids given are to help the lungs of your baby mature more quickly, thus reducing the risk of the baby dying or suffering from breathing problems called respiratory distress syndrome(RDS) at birth.

The steroid is usually given by the intramuscular route. The most common one used is betamethasone. It is given in two doses of 12 mg each, at 12 hours apart. The medication is most effective from two to seven days after the first dose. With this treatment, the risk of baby having RDS is reduced by half and the chances of survival improve by up to 40 percent. Other complications in the baby such as bleeding in the brain and damage to the intestines are also less.

Although studies in animals have suggested that steroids given to mothers during pregnancy can affect the immune system, neurological development, and growth of their offspring, such effects have not been seen in human studies. Long term studies of infants whose mothers were given steroids during pregnancy until the children were twelve years old did not show any adverse effects of the drug on the child's physical growth or development.

For the mother, corticosteroid injections do not appear to increase the chances of infections of the womb.

The use of this drug is an important recent advance in caring for pregnant women at risk of premature birth. The American College of Obstetricians and Gynaecologists has recommended that a single course of corticosteroids be given for pregnant women between 24 weeks and 34 weeks of gestation who are at risk of preterm delivery, within 7 days, including for those with ruptured membranes and multiple gestations.

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