Moore L E, Martin J N
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, USA.
J Perinatol. 2001 Oct-Nov;21(7):456-8. doi: 10.1038/sj.jp.7210601.
To review the literature on alternatives to betamethasone and dexamethasone for enhancement of fetal lung maturity.
A medline search was conducted from 1966 to the present. Trials dealing with enhancement of fetal lung maturity using modalities other than betamethasone or dexamethasone were reviewed.
Eight studies met inclusion criteria. Excluding betamethasone and dexamethasone, the most frequently studied glucocorticoids, for fetal lung maturation, are methylprednisolone and hydrocortisone. Methylprednisolone does not cross the placenta. Two grams of hydrocortisone has been shown to improve indices of fetal lung maturity (i.e., L/S ratio) and to improve fetal outcomes compared to no treatment.
There is limited information about alternatives to betamethasone and dexamethasone for the enhancement of fetal lung maturity in women at risk of preterm delivery. In the absence of these two preferred drugs, hydrocortisone can be given at a dose of 500 mg intravenously every 12 hours for four doses for this indication.
回顾关于倍他米松和地塞米松以外用于促进胎儿肺成熟的替代药物的文献。
对1966年至今的医学文献数据库进行检索。对使用倍他米松或地塞米松以外的方法促进胎儿肺成熟的试验进行综述。
八项研究符合纳入标准。除倍他米松和地塞米松外,用于胎儿肺成熟研究最频繁的糖皮质激素是甲泼尼龙和氢化可的松。甲泼尼龙不能穿过胎盘。与未治疗相比,已证明2克氢化可的松可改善胎儿肺成熟指标(即L/S比值)并改善胎儿结局。
关于倍他米松和地塞米松以外用于促进有早产风险妇女胎儿肺成熟的替代药物的信息有限。在没有这两种首选药物的情况下,针对该适应症,氢化可的松可每12小时静脉注射500毫克,共四剂。