Michelle Clement

The Antenatal Corticosteroids (ACS) Dexamethasone and Betamethasone An Overview Of The Uses Of These Steroids For Pregnant Mothers Report By Michelle Clement- REAL SCIENCE INTRODUCTION The steroids dexamethasone and betamethasone are antenatal corticosteroids (ACS) utilized for the acceleration of fetal lung development at the preterm birth phase. International agencies responsible for health and wellbeing such as WHO, RCOG, ACOG, NIH and WAPM have stated that these drugs work effectively against complications caused by prematurity. USES OF THESE STEROIDS Both steroids are used to treat women exhibiting signs of preeclampsia and may be administered between 24 to 34 weeks of pregnancy. In practice, 24mg of dexamethasone may be given at 4 doses of 6 mg 12 hours apart and 24 mg betamethasone may be administered at 2 doses of 12 mg 24 hours apart. While these steroids may be used interchangeably, according to guidelines by WAPM, betamethasone has been preferred. However, because dexamethasone is more readily available and cost effective, it is often the most appropriate treatment for ACS. In terms of safety and efficacy, both dexamethasone and betamethasone are acceptable. While some studies in 2006 compare 6 trials using dexamethasone and 14 trials using betamethasone, it was found that betamethasone was more effective in reducing RDS (44% vs 20%), while reduction in mortality was comparable (33% vs 28%). In pregnant women, it is used to moderate the progression of pre-eclampsia and increase gestational age. It has been shown to have anti-inflammatory effects, working to reduce blood pressure and improve liver functions. It also increases blood flow of the descending aorta, umbilical artery, the maternal uterine artery (UA) and fetal middle cerebral artery (MCA). When administered to women at risk of preterm labor, it has been reported to have positive effects in as little as 24 hours. The report on 9 studies in 2008 revealed substantially greater reduction in intraventricular hemorrhage (IVH) for dexamethasone, with no other statistical difference in primary outcomes for those reports which actually compared primary outcomes. While dexamethasone is recommended because of its effectiveness, safety, availability and lower cost, there are reports of maternal sepsis. However, it is regarded as a safe drug, having better outcomes in the reduction of IVH and is equally acceptable for clinical usage. Dexamethasone is a glucocorticoid that treats skin diseases, asthma, severe allergies, obstructive lung disease, rheumatic problems, crop and brain swelling. Betamethasone can be used to treat multiple sclerosis, arthritis, skin disease, eye disorders, kidney problems, breathing disorders, blood disorders, cancer and arthritis. The treatments 1 are available through injections, topical creams, gel, lotions, ointments, sprays or foams. It is worth noting that Betamethasone is more costly and less stable than Dexamethasone at high temperatures. SIDE EFFECTS Dexamethasone Common 1. Swelling 2. Rapid weight gain 3. Sleep problems 4. Mood changes 5. Acne 6. Dry skin 7. Thinning skin 8. Bruising or discoloration 9. Slow wound healing 10. Increased sweating 11. Headache 12. Spinning sensation 13. Nausea 14. Stomach pain 15. Bloating 16. Muscle weakness 17. Changes in the shape or location of body fat Betamethasone Common 1. Increased blood sugar levels. Symptoms may include: ● Confusion ● Frequent urination ● Sleepiness, thirst, hunger 2. Trembling, dizziness, weakness, fatigue and increased heartbeat 3. Low potassium levels leading to possible muscle pain and cramps 4. Skin changes such as: ● Pimples ● Stretch marks ● Slow healing ● Hair growth 5. Signs of infection including: ● Fever ● Cough ● Sore throat 6. Mood and behavior changes 7. Menstrual changes which may involve spotting or skipping of periods 8. Vision changes, inclusive of blurred vision 9. Headaches 10. Weight gain 11. Sweating 12. Restlessness 2 Serious Side Effects - Doctors are to be called immediately for the following: 1. Allergic reactions/anaphylaxis 2. Aggression or agitation 3. Anxiety or irritability 4. Blurred vision 5. Reduced urine 6. Dizziness 7. Irregular heart beat or pulse either fast or slow beats 8. Headache 9. Depression 10. Mood changes 11. Nervousness Serious Side Effects - Doctors are to be called immediately for the following: 1. Wheezing 2. Chest tightness 3. Fever 4. Swelling in face, lips, tongue or throat 5. Seizure 6. Blue skin color 7. Infection with symptoms of cough CONCLUSION The steroids betamethasone and dexamethasone are applicable to a variety of medical uses. They are most commonly used for the moderation of prenatal preeclampsia and have been highly recommended for such treatments with positive results. Despite having side effects as stated, they are widely used. However, dexamethasone is preferred because of affordability and availability considerations. REFERENCES https://obstetrics.imedpub.com/the-effect-of-dexamethasone-on-the-preeclampsticprocess--a-brief-reprieve-up-to-day4.php?aid=8315#:~:text=Up%20to%20day%204%2C%20dexamethasone,significa nt%20gain%20in%20gestational%20age. https://www.researchgate.net/publication/-_The_Effect_of_Dexamethas one_on_the_Pre-_Eclampstic_Process_A_Brief_Reprieve_up_to_Day_4_Summary https://chempartner.com/2020/07/01/the-story-of-dexamethasone/ 3