MEMBRAN DISEASE ON INFANTS FROM PREGNANT WOMAN 35 AND 36 WEEKS WITH AND WITHOUT ADMINISTRATION OF CORTICOSTEROIDS
By: dr. Teuku Renardiansyah Akhmad Supervisor: Dr. dr. Udin Sabarudin, SpOG(K), MM, MHKes
OBSTETRIC DAN GYNEKOLOGY DEPARMENT
FACULTY OF MEDICINE UNIVERSITAS PADJADJARAN Dr. HASAN SADIKIN GENERAL HOSPITAL BANDUNG 2014
INCIDENCE DIFFERENCE OF ASPHYXIA AND HYALIN MEMBRAN
DISEASE ON INFANTS FROM PREGNANT WOMAN 35 AND 36 WEEKS WITH AND WITHOUT ADMINISTRATION OF CORTICOSTEROIDS Teuku Renardiansyah Akhmad, Udin Sabarudin Obstetric and Gynekology Departmen Dr.Hasan Sadikin General Hospital Based on the literature corticosteroids indeed play an important role in reducing the incidence of respiratory complications on preterm labor. (4) In this study, the evaluation was conducted in preterm labor which given corticosteroids at the age of 35 and 36 weeks gestation. There are 106 patients threat with preterm labor atgestational age between 35 and 36 weeks, in which 53 patients received corticosteroids and 53 patients did not receive corticosteroids. In the discussion shows that the administration of corticosteroids at the age of 35 and 36 weeks of pregnancy is statistically significant on asphyxia, but not in the incidence of hyaline membrane disease, or duration of treatment. In previous studies on the use of corticosteroids for lung maturation in 1972 mentioned that bethametasone may decrease respiratory complications as much as 25.8% in the control group compared to 9.0% in the group receiving therapy.(8) At birth at the age of 35 and 36 weeks gestation in fact there are many other factors that can affect the incidence of respiratory disorders besides surfactant deficiency, but with corticosteroids administration it was expected natural surfactants that are formed can exceed the minimum threshold for the development of alveoli. (9) Babies born at this period are immature as in physiologically and metabolic functions. It can cause a variety of disorders in the early stages of life. (10) Cause of respiratory disorders most frequently occur are transient tachypnea of the newborn as a result of delays in the lung fluid absorption resulting in an accumulation of fluid that may reduce lung capacity. (2) A variety of problems that can arise in these infants will lead to a longer treatment compared to other normal baby and the possibility of intensive care. (10) this is consistent with the recommendations issued by the ACOG that elective delivery therapy is not recommended in pregnancy under 39 weeks considering various morbidities that may occur. (11) Other factors that can affect is the timing of antenatal corticosteroids. In patients with deliveries occurred within 24-72 hours after complete administration of corticosteroids show better effects than the more than 72 hours. The administration of corticosteroids besides accelerating the growth of the lung, have other effects that would arise at the age of 2 years, it may resulting a neurological disorders or insulin resistance. A research followed the development of children who received
corticosteroids mentioned, the increased incidence of cerebral palsy, blindness, hearing
loss and cognition at age 2 years. (12) In addition, other study that followed up until the early days of elementary school mentioned there is attention disorders in children. (13 ) Limitations of this study was not able to follow the late side effects that may arise in the administration of corticosteroids at 36-36 weeks gestation because of time limitation. Currently administration ofcorticosteroids protocol in Dr. Hasan Sadikin General Hospital refers to the protocol issued by ACOG, it is given at the age of 24 pregnancies and 33 6/7 weeks. With this study it can be concluded that the protocol can be adjusted for corticosteroids in Dr Hasan Sadikin General Hospital because there are significant advantages in administration of corticosteroids in pregnancy over 34 weeks. IV. CONCLUSION There are differences in the incidence of asphyxia infants born from 35-36 weeks pregnant women with and without corticosteroids. There is no difference in the incidence of HMD infants born from 35-36 weeks pregnant women with and without corticosteroids.