June 2021 · Volume 10 · Issue 6 Page 2312 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Akhtar N et al. Int J Reprod Contracept Obstet Gynecol. 2021 Jun;10(6):2312-2315 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Original Research Article Antenatal rescue corticosteroids and perinatal outcome Nishat Akhtar, Parul Singh, Naghma Shahrukh, Aleena Haider* INTRODUCTION ACS have been used for long to improve the neonatal outcome in preterm babies. Corticosteroids accelerate organ maturation that enables the foetus to survive outside the womb. In preterm birth, the developing foetus does not receive sufficient exposure to endogenous corticosteroids in utero for proper organ development, predisposing the neonate to complications like intraventricular haemorrhage (IVH), RDS, necrotizing enterocolitis (NEC) and sepsis. 1 Synthetic corticosteroids have proved useful in the prevention of these complications. Betamethasone and dexamethasone are the most widely studied ACS .2-4 Although the beneficial effects of ACS on the foetus are very well known, many studies have suggested a transient effect of ACS. 5-7 Thus, we give a single repeat course of antenatal corticosteroids, also termed as salvage, rescue or booster therapy. The concept of a rescue course of ACS basically involves administering a second course of antenatal corticosteroids to mothers with preterm labour, whose pregnancy continues for more than a week or two beyond their original ACS course. Currently, ACOG 2017 recommends a single repeat course of ACS for those pregnant women who are less than 34 0/7 weeks of gestation, who are at risk of preterm delivery within 7 days and whose prior course of ACS was administered more than 14 days previously. 8 In the context of inaccessibility and unaffordability of advanced neonatal interventions in developing countries a DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20212168 Department of Obstetrics and Gynaecology, JNMCH, AMU, Aligarh, Uttar Pradesh, India Received: 22 April 2021 Accepted: 12 May 2021 *Correspondence: Aleena Haider, E-mail: aleenahaider447@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Antenatal corticosteroids (ACS) is one of the most effective intervention for prevention of neonatal complications in preterm babies. However, due to its transient effects, single repeat course is recommended. This rescue course of ACS is believed to improve feto-maternal outcome in women with preterm labor and was the subject matter of this study. Methods: Total 200 antenatal women who were admitted for threatened preterm labor, between 28 to 34 weeks of gestation, who had already received a single course of ACS within 7-14 days were allocated into group A and group B. Group A included 100 women, who were given rescue course of ACS. Group B included 100 women who rescue course was not given. Results: Out of 115 babies in group A and 114 babies in group B, 18 babies (16%) in group A and 30 babies (26%) in group B had NICU admission (p<0.05). Eight babies (6%) in group A and 23 babies (20%) in group B were diagnosed with respiratory distress syndrome (RDS) where the difference was statistically highly significant (p<0.001). Maternal outcome was similar among both the groups. Conclusions: A single repeat rescue course of ACS helps to improve neonatal outcome in preterm babies. Keywords: Antenatal corticosteroids, Respiratory distress syndrome, Preterm labor