The Effect of Dexamethasone Therapy in Prolonged Pregnancy

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Abstract
Patients (56) chosen by random sampling from a total group of 120 post-term women received dexamethasone (Decadron, MSD) 2 mg 3 times a day for 4 days, the other 64 patients acting as controls. The evolution of uterine activity was evaluated using pelvic score (PS) and a modified low dosage oxytocin sensitivity test (OST) before (T1) and after (T2) the treatment. During the interval from the 2nd-6th day inclusive after T1, 35 women of the dexamethasone group and 15 of the control group had a spontaneous onset of labor (SO) (0.001 < P < 0.01). Five patients in the dexamethasone group with primary rupture of membranes started labor spontaneously within 12 h after membrane rupture, while 7 patients in the control group with primary rupture of membranes received oxytocin as labor did not start within 24 h. Excluding patients artificially induced, the mean interval from T1 to SO was 6.8 days in the control group and 5.2 days in the dexamethasone group (P < 0.001). In both groups PS and the sum of Montevideo units (MU) during OST increased from T1 to T2, the increase being significantly greater in the dexamethasone group than in the control group. No correlation was found between the results of OST and the T1-SO interval. Dexamethasone may promote labor in prolonged human pregnancy. Due to its low potency, it is not a substitute for oxytocin in the induction of labor.