A Cochrane meta-analysis reinforces the beneficial effect of this therapy regardless of membrane status and concludes that a single course of antenatal corticosteroids should be considered routine for all preterm deliveries 11 12. While the total dosage was based on efficacy found in animal studies, the NIH admits the two dose regimen was chosen arbitrarily.To better understand the importance of administering betamethasone 24 hours versus 12 hours apart, Dr. Meena Khandelwal, from the department of obstetrics and gynecology at Cooper University Hospital in Camden, New Jersey and the University of Medicine and Dentistry of New Jersey, and colleagues conducted a prospective, randomized, semi-blinded noninferiority study comparing the two treatment regimens.

antenatal corticosteroids, magnesium sulfate and antibiotic prophylaxis). Initial dose: 0.02 to 0.3 mg/kg/day intramuscularly in 3 or 4 divided doses Comments:-Dose requirements are variable; individualize dose based on disease and patient response.-When a favorable response is achieved, determine maintenance dose by decreasing the dosage in small decrements; use the smallest dose needed for adequate clinical response. It includes recommendations for iron supplementation in countries where malaria is prevalent...The primary audience for this guideline includes health-care professionals who are responsible for developing national and local health-care protocols and policies, as well as managers of maternal and child health programmes and policy-makers in all settings. The most common steroid, betamethasone (Celestone), is given in two doses, 12 mg each, 12 … (3-5) With the increasing contribution of neonatal deaths to overall child mortality, it is critical to address the determinants of poor outcomes related to preterm birth to achieve further reductions in child mortality. (1)  Globally, it is the leading cause of perinatal and neonatal mortality and morbidity. (2) Preterm infants are particularly vulnerable to complications due to impaired respiration, difficulty in feeding, poor body temperature regulation and high risk of infection.

(6-8)Infant mortality and morbidity from preterm birth can be reduced through interventions delivered to the mother before or during pregnancy, and to the preterm infant after birth. Either intramuscular (IM) dexamethasone or IM betamethasone (total 24 mg in divided doses) is recommended as the antenatal corticosteroid of choice when preterm birth is imminent.Preterm birth, defined as birth before 37 weeks of gestation, is the single most important determinant of adverse infant outcomes, in terms of survival and quality of life. Three of the trials were conducted in the USA, two in France and one trial each in Iran, Israel, the Netherlands, Poland, Taiwan and the United Kingdom, as well as a two-centre study in Italy and Israel.There were no significant differences in most critical infant outcomes between groups receiving dexamethasone and those receiving betamethasone.One study with data for 183 women compared oral (32 mg 12-hourly) with intramuscular (24 mg 12-hourly) dexamethasone.One trial with data for 255 women compared 12 mg doses of betamethasone every 12 hours versus 24 hours.Further information and considerations related to this recommendation can be found in the WHO guidelines, available at:The GDG identified these priority questions related to antenatal corticosteroids for imminent preterm birth recommendations:WHO recommendations on interventions to improve preterm birth outcomes (2015) –This video provides an overview of performance of catheterization of the bladder.This video highlights the importance of social support provided by lay labour companions (doulas) during labour.External cephalic version is one of the most effective procedures for reducing breech presentation and avoiding caesarean section. The use of progressively higher concentrations of oxygen should only be considered for...In intubated preterm newborns with respiratory distress syndrome, surfactant should be administered early (within the first 2 hours after birth) rather than waiting for the symptoms to worsen before giving rescue therapy.Administration of surfactant before the onset of respiratory distress syndrome (prophylactic administration) in preterm newborns is not recommended.WHO recommendation on use of either dexamethasone or betamethasone as the antenatal corticosteroid of choice

Medical eligibility criteria for contraceptive use (MEC), the first edition of which was published in 1996, presents current WHO guidance on the safety of various contraceptive methods for use in the context...During ventilation of preterm babies born at or before 32 weeks of gestation, it is recommended to start oxygen therapy with 30% oxygen or air (if blended oxygen is not available), rather than with 100% oxygen.

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