The SMFM and ACOG recommend antenatal corticosteroids for fetal lung maturity in women at risk of preterm birth. For a woman presenting at 34+2 weeks with threatened preterm labour, which of the following is currently recommended?
- A No steroids — gestational age is too advanced
- B Single course betamethasone 12 mg IM × 2 doses 24 hours apart ✓
- C Dexamethasone 6 mg IM × 4 doses 12 hours apart
- D Rescue course of betamethasone if a prior course was given >2 weeks ago
Correct answer: B. Single course betamethasone 12 mg IM × 2 doses 24 hours apart
Explanation
ACOG (Committee Opinion 2017, updated 2021) and SMFM recommend a single course of betamethasone (12 mg IM every 24 hours × 2 doses) for women between 34+0 and 36+6 weeks at imminent risk of preterm birth within 7 days who have not previously received corticosteroids. This 'late-preterm' steroid course (supported by the ALPS trial, NEJM 2016) reduces respiratory morbidity, TTN, surfactant use, and NICU admission. Both betamethasone and dexamethasone are acceptable, but betamethasone is preferred by ACOG for its sustained-release formulation.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.