بررسی میزان سرکوب آدرنال توسط بتامتازون در خانم های با ریسک زایمان زودرس

Betamethason Causes adrenal suppression in woman at risk of pre‌term delivery.Materials and Methods: An interventional study was done on 25 women at risk of pre-term delivery, Betamethason course (12-mg-im q 24 hr for 2 doses) was prescribed for 2 consecutive weeks. ACTH Stimulation test was done one week after each Betamethason injection. (1st between 30-31 w and the 2nd one week later. Serum Cortisol levels were measured before betamethason administration and then before and 30 minutes after ACTH Stimulation test.Results: All Subjects had normal baseline Cortisol level. Mean baseline serum Cortisol levels decreased with each ACTH stimulation test from 24.32±0.77 ug/dl ( before Betamethason) to 7.33±1.73 ug/dl ( one week after the second course of Betamethasone) (p < 0.0001). The mean stimulated Cortisol levels also decreased from 23.93±1.44, ug/dl (befor Betamathason) to 19.53=+2.69 (one week after the second course of Betamethasone) (P<0.007), compared with initial ACTH stimulation test. Laboratory evidence of adrenal suppression (Cortisol < 6 ug/dl) observed in three patients one week after the first course of betamathasone injection and in 15 patienst after the second course. No sign or symptom of Addisonian Crisis occurred antepartum or intrapartum.Conclusion: Antenatal administration of Betamethasone caused measurable adrenal suppression in women at risk of preterm delivery. The number of women with adrenal suppression increased each week that antenatal betamethason was repeated.