New technique for artificial lung maturation. Direct intramuscular fetal corticosteroid therapy

Abstract

The aim of this study was to present a new technique of administration of antenatal corticosteroid therapy in order to cause fetal lung maturation. A single dexamethasone dose of 4 mg was applied directly to the fetal gluteal musculature by ultrasound-guided intramuscular injection 48 h before delivery. This technique of fetal corticosteroid therapy was applied in six cases. Our patients had high risk pregnancies (preeclampsia diabetes mellitus, intracranial hemorrhage, epilepsy, hyperthyreosis). The pregnancies were terminated in the mother's vital interest. The lecithin/sphyngomyelin (US) ratio was < 1.5:1. There were no procedure-related complications. The fetuses were delivered by cesarean, 48 hours later except for the vaginal delivery in the patient in which fetal death occurred in utero. In five cases an uneventful outcome of fetuses indicated that direct fetal corticosteroid treatment improved postnatal lung function in preterm fetuses. A new technique of corticosteroid application successfully prevents respiratory distress in preterm infants decreasing the risk of maternal complications. To our knowledge, this is the first report of fetal intramuscular corticosteroid therapy in the human population.