Dexamethasone Effect on Induction-delivery Interval at Term Randomized Controlled Trial

Abstract

ABSTRACT Background: Induction of labor is one of the most common interventions practiced in modern obstetrics. In the developed World, the ability to induce labor has contributed to the reduction in maternal and perinatal mortality and morbidity. During pregnancy, large amounts of CRH are released from the placenta and fetal membranes. An increment in plasma CRH concentration occurs during spontaneous labor, with peak value at vaginal delivery. Aim: The aim of this study is to establish whether Dexamethasone plays a role in shorting the duration interval between initiation of labor induction and beginning of the active phase of labor in primigravida post-term pregnancy, so shorting the duration of labor. Methodology: This randomized controlled trial was conducted at Ain-Shams University Maternity Hospital. 102 full term & post-term (≥ 40 weeks) nulliparous women were included in this study and divided into the following: Group I (Dexamethasone group) injected with 2 ml (8 mg) dexamethasone intravenously 4 hours before initiation of labor induction and Group II (placebo group) will not receive dexamethasone or any other cervical ripening agent. Results: There was a non-significant statistical difference between the two studied groups as regards the age, gestational age on admission, body mass index (BMI), pulse, systolic, diastolic blood pressure, primary cervical dilatation, effacement, cervical position, consistency, head station, Bishop Score, mode of delivery and Apgar score. Conclusion: Single intra-venous injection of two ml. (8mg.) of dexamethasone before induction of labour appears to shorten labor duration. Recommendations: Intra- venous injection of dexamethasone a dose of 2 ml. (8 mg) is a safe and effective dose for shorting labor duration. Larger randomized controlled studies should be carried out for longer duration to reach the safest regimen of dexamethasone before induction of labor.