Medical students on their OBGYN rotations have long memorized the corticosteroid rule: If delivery is imminent in the next week, before 34 weeks gestational age, give corticosteroids for lung maturity. Two doses, 24 hours apart have been shown to improve respiratory outcomes in strong, randomized clinical trials. However, what about the 70% of preterm deliveries that occur between 34 weeks and 36 weeks 6 days? Do these infants benefit from corticosteroids? The Society for Maternal Fetal Medicine is spreading the word about the new ALPS study on this very topic.
Most of our parents didn’t get to choose our birthdays, but in the case of scheduled deliveries, exactly which day to plan for delivery is an important question for doctors and patients. The American College of Obstetrics and Gynecology (ACOG) and the Society for Maternal Fetal Medicine (SMFM) currently recommend delivery for dichorionic-diamniotic (di-di) twins during the 38th week of pregnancy. A new meta-analysis calls this recommendation into question, with results suggesting that delivery at 37 weeks could decrease stillbirths.