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Antenatal Steroid Selection
When Betamethasone and Dexametha-sone are Unavailable: Hydrocortisone. Moore LE and Martin JN. J Perinatol 2001 (Oct/Nov); 21:456-8.
Eight trials dealing with enhancement of fetal lung maturity using modalities other than betamethasone and dexamethasone were reviewed. Hydrocortisone has also been shown to improve the indices of fetal maturity (i.e. the L/S ratio) and to improve fetal outcomes. The dose of hydrocortisone for this indication is 500 mg IV q12h for 4 doses. Methylprednisalone should not be used for this indication, since it does not cross the placenta.
Comment. In light of the recent problems we’ve had with the availability of both betamethasone and dexamethasone, it’s nice to know that there is another alternative (i.e. hydrocortisone) that has been shown to be effective for this indication.
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