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Giving steroids before elective caesarean section

BMJ 2005; 331 doi: (Published 22 September 2005) Cite this as: BMJ 2005;331:645
  1. Philip J Steer (, professor of obstetrics
  1. Imperial College, Chelsea and Westminster Hospital, London SW10 9NH

    Neonatal respiratory morbidity is halved, but they may be harmful in the long term

    In recent years the caesarean section rate in developed countries has been rising. This may be because improved techniques to control haemorrhage, infection, and thromboembolism have increased the safety of the procedure. As a result obstetricians and pregnant women have a reduced threshold for choosing it. However, although maternal risks have decreased, the effects on the baby of surgical delivery before the due date continue to be debated.'

    In this issue (p 662), Stutchfield et al confirm previous reports that elective caesarean section before 40 weeks' gestation increases neonatal admissions to the special care unit for respiratory distress (mainly for transient tachypnoea of the newborn).12 In the control group of the randomised controlled trial, 11.4% were admitted at 37 weeks, 6.2% at 38 weeks, and 1.5% at 39 weeks. If women were given two intramuscular injections of 12 mg of betamethasone in the …

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