Overview
Introduction
When preterm birth is likely, antenatal corticosteroids give the fetus time to prepare for life outside the uterus.
When preterm birth is likely, antenatal corticosteroids give the fetus time to prepare for life outside the uterus. Betamethasone or dexamethasone crosses the placenta and accelerates fetal lung maturation, especially surfactant production. The result is a lower risk of respiratory distress syndrome and important reductions in intraventricular hemorrhage and perinatal mortality when treatment is used before early preterm birth. This is not a medication given to every pregnant person with contractions. The decision depends on gestational age, the likelihood of delivery within 7 days, the condition of the pregnant person and fetus, and whether a previous course has already been given. The benefit is time-dependent: a complete course is helpful, but an urgent delivery should not be delayed solely to finish the injections. For the nurse, the clinical pattern is straightforward: confirm that the pregnancy and delivery risk fit the treatment window, administer the ordered intramuscular regimen safely, anticipate steroid-related hyperglycemia and blood pressure changes, and continue assessing both fetal and maternal status.