Practice of antenatal corticosteroid for fetal maturation: A survey among obstetricians of Delhi

Administration of antenatal cortico-steroids (ACS) for fetal maturation, a proven cost-effective intervention, results in 25–50% reduction in neonatal mortality. However the practice of ACS administration has been reported to be variable among health care providers.

To determine the practice pattern regarding ACS administration among obstetricians of Delhi.

population survey of obstetricians practicing in Delhi.

A sample of 147 registered members of Association of Gynaecologists and Obstetricians of Delhi was randomly selected. Interview of 96 of 147 selected participants was conducted using a structured questionnaire.

Data were expressed as percentage. EPI Info version 6 was used for analysis.

Most participants were MD with 5–10 yr of experience and were working in non-teaching hospital settings. A majority (83.3%) of participants were following practice of ACS administration for fetal maturation in preterm labour. However a significant proportion of them were not adhering to National Institute of Child Health & Human Development recommendations for use of ACS. ACS was being used in situations without valid indications and was not being used in situations with valid indications such as pregnancy induced hypertension (31.3%), diabetes mellitus (52.1%) and preterm premature rupture of membrane (50.0%). A significant proportion of participants were inappropriate in selection of patients and used dosage schedule not conforming to the NICHD recommendations. Dexamethasone (42.7%) was the preferred drug over betamethasone (20.8%). Administration of repeat course of ACS was common (70.8%). Most participants perceived ACS to be safe.

The practice of ACS administration for fetal lung maturation has percolated well among practicing obstetricians of Delhi. However significant deviation form NIH recommendation is a common place signifying the need for effective in-service education.