The purpose of this study was to evaluate the influence of dexamethasone administration on selected markers of infection during the expectant management of premature rupture of membranes (PROM).
Materials and methods: A group of 80 patients with PROM before 35 weeks' gestation were evaluated prospectively and managed expectantly. All patients were managed in the hospital. All pregnancies had ultrasonographic evaluations to confirm gestational age, rule out lethal anomalies, and document oligohydramnios. We applied the expectant management with the permanent use of tocolysis, antibiotics, steroids (4 mg of dexamethasone every 8 hr for 2 days, every week), amnioinfusions of artificial amniotic fluid and intravaginal chemotherapeutics. Patients were monitored with frequent vital signs, fetal heart rate evaluation and everyday blood tests as follows: C-reactive protein (CRP), white blood cell count (WBC) and erythrocyte sedimentation rate (ESR). After completing 25 weeks antenatal fetal surveillance included a nonstress test at least once a day. All afterbirths were examined to establish the presence of histologic chorioamnionitis. In order to eliminate the influence of intrauterine infection we analyzed only the results obtained of patients without histologic chorioamnionitis (n = 24).
Results: WBC raised significantly in the first day of steroidotherapy (mean: 14,895/mm3), was elevated in the second day (15,716/mm3) and the day after (15,100/mm3), and decreased to the normal limit in the second day after steroids (12,316/mm3); p < 0.001. There were no statistically significant differences in the results of CRP and ESR connected with the administration of dexamethasone.
Conclusions: Dexamethasone administration caused the independent of infection and temporary elevation of WBC. We did not observe such influence on the results of CRP and ESR.