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MRCOG PART 2 SBAs and EMQs

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EMQ1500
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PProm and steroid adm

PProm and steroid adm Posted by zainab K.

Mcq says IDDM and chorioamnionitis is a relative contraindication while the guide line recomends its administration please clarify

Posted by Farrukh G.

You should not administer corticosteroids if you make a diagnosis of chorioamnionitis. This is not because they are unsafe but because you should not wait 24h to initiate delivery. It is inappropriate to administer corticosteroids and initiate delivery at the same time.

 

With respect to IDDM, relative contra-indications does not mean the drug should not be administered. You should consider risks and benefits. There is little evidence that steroids are effective in diabetics and the potential for maternal hyperglycaemia around the time of birth causing neonatal hypoglycaemia should be considered.

Posted by Jandy F.

I think it is we can go by guidelines as if we need the steroids in, we can put mum on the sliding scale to control steroid related hyperglycemia