ABSTRACT
Objective:To investigate the rate and timing of antenatal corticosteroid administration in the singleton preterm infants in our hospital, and explore the relationship between the timing of antenatal corticosteroid administration associated with the causes of preterm delivery and with neonatal outcomes.Methods:The study was a retrospective chart review of clinical data regarding singleton preterm neonates and their mothers from January 2016 and June 2020 at Peking University International Hospital.Optimal administration timing was defined as the first dose of antenatal dexamethasone given ≥48 h and ≤7 d before delivery.Suboptimal administration timing included any antenatal dexamethasone timing(<48 h or >7 d) that did not meet the optimal criteria.Antenatal dexamethasone administration timings were compared among preterm delivery with different causes.The neonatal outcomes of the optimal and suboptimal administration timing groups were compared.Results:The percentage of antenatal dexamethasone use was 89.16%, with 51.35% receiving optimal dexamethasone.Women with premature rupture of membranes were most likely to receive optimal dexamethasone(63.79%), followed by women with complications of pregnancy and other disorders(54.29%). The optimal dexamethasone rate of the women with cervical incompetence and preterm labor was relatively low(20% and 28%, respectively). The incidence of respiratory distress syndrome(RDS) of optimal administration timing group was lower than that in suboptimal administration timing group among neonates at <34 weeks of gestation( P<0.05). But there was no significant difference in the incidence of severe RDS, bronchopulmonary dysplasia, and need for pulmonary surfactant between two groups( P>0.05). The preterm infants with a gestational age between 34 and 34 + 6 weeks had no severe RDS or bronchopulmonary dysplasia.Compared with suboptimal administration timing group, the incidence of RDS and need for pulmonary surfactant of optimal administration timing group did not decrease significantly( P>0.05). Conclusion:The causes of preterm delivery affect the timing of antenatal dexamethasone administration.Optimizing the timing of antenatal dexamethasone administration can reduce the incidence of RDS among neonates less than 34 weeks of gestation.
ABSTRACT
OBJECTIVE:To explore the effect of administration timing of mannitol on efficacy and related indexes of patients with moderate cerebral hemorrhage. METHODS:Data of 280 patients with moderate cerebral hemorrhage being treated with manni-tol were divided into super-early group(65 cases),early group(97 cases)and extension group(118 cases)was analyzed retrospec-tively according to administration timing. All patients received conservative medical treatment,ntrition brain cells and other symp-tomatic and supportive treatment. Based on it,super-early group received mannitol within 6 h of cerebral hemorrhage,early group received mannitol within 6-24 h,and extension group received mannitol more than 24 h. Clinical efficacy,incidence of hematoma enlargement,mortality,incidence of continued bleeding/rebleeding and incidence of adverse reactions in 3 groups were observed. RESULTS:The incidences of hematoma enlargement and mortality in early group and extension group were significantly lower than super-early group,the differences were statistically significant (P0.05). The total effective rate in early group was significantly higher than super-early group and extension group,the incidence of continued bleeding/rebleeding was significantly lower than super-early group and extension group,the differences were statistically significant (P0.05). CONCLUSIONS:Based on conventional treatment,mannitol shows better efficacy for patients with moderate cerebral hemorrhage within 6-24 h of cerebral hemorrhage than those in super-early or extension. It can reduce continued bleeding/rebleeding incidence,and has equivalent safety.