Management of fetal maturation with corticosteroids during pregnancy

Abstract

Historically, maturation was performed on all pregnant women with a pregnancy complicated by diabetes mellitus (DM). Two doses were administered and then repeated a week later. No decrease in the risk of respiratory distress was observed, leading to premature termination of pregnancy.

We now know that maternal hyperglycemia generates fetal hyperinsulinemia, which decreases the effect of fetal cortisol on pneumonocyte maturation and surfactant production.

Therefore, maturation with corticosteroids should only be indicated when there is a risk of preterm delivery, regardless of the reason. Since corticosteroids generate hyperglycemia, monitoring should be strict and should be performed under hospitalization conditions.

We can conclude that maturation should only be performed on pregnant women when there is an obstetric indication for preterm delivery, and certainly under hospitalization, regardless of the type of diabetes.