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PIT POGI 21

INCIDENCE DIFFERENCE OF ASPHYXIA AND HYALIN


MEMBRAN DISEASE ON INFANTS FROM PREGNANT WOMAN
35 AND 36 WEEKS WITH AND WITHOUT ADMINISTRATION
OF CORTICOSTEROIDS

By:
dr. Teuku Renardiansyah Akhmad
Supervisor:
Dr. dr. Udin Sabarudin, SpOG(K), MM, MHKes

OBSTETRIC DAN GYNEKOLOGY DEPARMENT


FACULTY OF MEDICINE UNIVERSITAS PADJADJARAN
Dr. HASAN SADIKIN GENERAL HOSPITAL
BANDUNG
2014

INCIDENCE DIFFERENCE OF ASPHYXIA AND HYALIN MEMBRAN


DISEASE ON INFANTS FROM PREGNANT WOMAN 35 AND 36 WEEKS
WITH AND WITHOUT ADMINISTRATION OF CORTICOSTEROIDS
Teuku Renardiansyah Akhmad, Udin Sabarudin
Obstetric and Gynekology Departmen
Dr.Hasan Sadikin General Hospital
Based on the literature corticosteroids indeed play an important role in reducing
the incidence of respiratory complications on preterm labor. (4) In this study, the
evaluation was conducted in preterm labor which given corticosteroids at the age of 35
and 36 weeks gestation. There are 106 patients threat with preterm labor atgestational
age between 35 and 36 weeks, in which 53 patients received corticosteroids and 53
patients did not receive corticosteroids.
In the discussion shows that the administration of corticosteroids at the age of
35 and 36 weeks of pregnancy is statistically significant on asphyxia, but not in the
incidence of hyaline membrane disease, or duration of treatment. In previous studies on
the use of corticosteroids for lung maturation in 1972 mentioned that bethametasone
may decrease respiratory complications as much as 25.8% in the control group
compared to 9.0% in the group receiving therapy.(8) At birth at the age of 35 and 36
weeks gestation in fact there are many other factors that can affect the incidence of
respiratory disorders besides surfactant deficiency, but with corticosteroids
administration it was expected natural surfactants that are formed can exceed the
minimum threshold for the development of alveoli. (9) Babies born at this period are
immature as in physiologically and metabolic functions. It can cause a variety of
disorders in the early stages of life. (10) Cause of respiratory disorders most frequently
occur are transient tachypnea of the newborn as a result of delays in the lung fluid
absorption resulting in an accumulation of fluid that may reduce lung capacity. (2) A
variety of problems that can arise in these infants will lead to a longer treatment
compared to other normal baby and the possibility of intensive care. (10) this is
consistent with the recommendations issued by the ACOG that elective delivery therapy
is not recommended in pregnancy under 39 weeks considering various morbidities that
may occur. (11)
Other factors that can affect is the timing of antenatal corticosteroids. In patients
with deliveries occurred within 24-72 hours after complete administration of
corticosteroids show better effects than the more than 72 hours. The administration of
corticosteroids besides accelerating the growth of the lung, have other effects that
would arise at the age of 2 years, it may resulting a neurological disorders or insulin
resistance. A research followed the development of children who received

corticosteroids mentioned, the increased incidence of cerebral palsy, blindness, hearing


loss and cognition at age 2 years. (12) In addition, other study that followed up until the
early days of elementary school mentioned there is attention disorders in children. (13 )
Limitations of this study was not able to follow the late side effects that may arise in the
administration of corticosteroids at 36-36 weeks gestation because of time limitation.
Currently administration ofcorticosteroids protocol in Dr. Hasan Sadikin General
Hospital refers to the protocol issued by ACOG, it is given at the age of 24 pregnancies
and 33 6/7 weeks. With this study it can be concluded that the protocol can be adjusted
for corticosteroids in Dr Hasan Sadikin General Hospital because there are significant
advantages in administration of corticosteroids in pregnancy over 34 weeks.
IV. CONCLUSION
There are differences in the incidence of asphyxia infants born from 35-36
weeks pregnant women with and without corticosteroids.
There is no difference in the incidence of HMD infants born from 35-36 weeks
pregnant women with and without corticosteroids.