Which of the following is an indication for antenatal administration of glucocorticoids?

PGIMS Rohtak NO - 2017

Obstetrics & Gynaecology

Easy

Appeared in: PGIMS Rohtak NO - 2017

Explanation

The primary indication for administering antenatal glucocorticoids is the risk of preterm labor, typically between 24 and 34 weeks of gestation.
These steroids cross the placenta and accelerate the maturation of fetal lungs by stimulating the production of surfactant.
This action significantly reduces the incidence and severity of neonatal Respiratory Distress Syndrome (RDS), a major cause of morbidity and mortality in premature infants.
Additional benefits include a decreased risk of other complications of prematurity, such as intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC).

Option A: Antepartum hemorrhage (APH) is not a direct indication for glucocorticoids. The goal of steroid therapy is to mature the fetal lungs, not to stop maternal bleeding.
Option B: Postpartum hemorrhage (PPH) occurs after the baby is delivered. Antenatal glucocorticoids are given before birth and have no role in managing PPH.
Option D: Pre-eclampsia itself is not the indication. The treatment for pre-eclampsia is management of hypertension and, ultimately, delivery.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological interventions in high-risk pregnancy, specifically the use of antenatal corticosteroids as background academic context rather than a clinical decision trigger.
A key nursing responsibility is the timely administration of corticosteroid doses to ensure the full course is completed, ideally at least 24-48 hours before delivery, for maximum benefit.
Nurses must monitor the mother for side effects, particularly hyperglycemia (high blood sugar), as glucocorticoids can temporarily raise glucose levels. This is especially critical in patients with pre-existing or gestational diabetes.
Patient education is vital. The nurse should explain to the mother that the injection is not to stop labor but to help her baby's lungs develop, which can reduce anxiety and improve adherence.

How to Approach the Question

First, identify the core of the question: it asks for the primary reason ('indication') to give a specific class of drug ('glucocorticoids') during a specific time ('antenatal').
Recall the main function of antenatal glucocorticoids. Their most well-known use in obstetrics is to promote fetal development.
Evaluate each option based on this function. Ask yourself, 'In which of these situations would accelerating fetal maturity be the main goal?'
Option C, 'Preterm labour,' directly implies a baby will be born early and would benefit from accelerated lung development.
Consider the other options. 'Antepartum hemorrhage' and 'Pre-eclampsia' are maternal conditions. While they might lead to preterm labor, they are not the direct indication for the steroid. The steroid treats the consequence (prematurity), not the cause (hemorrhage or hypertension).
'Postpartum hemorrhage' occurs after birth, so an 'antenatal' medication is illogical. This allows you to eliminate it immediately.

Concept Tested & Keywords

Concept Tested: Pharmacological interventions in high-risk pregnancy, specifically the use of antenatal corticosteroids.
Stem keywords: antenatal administration, glucocorticoids, indication
Lead-in keywords: Which

QmVWYHDoPDpqkVqE8ZSCks

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 6-11

E6 Obstetrics Williams p. 40-58