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Butenaskin BM Pregnancy |
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Butenaskin BM crosses the placenta (Brownfoot 2013) and is partially metabolized by placental enzymes to an inactive metabolite (Murphy 2007). Some studies have shown an association between first trimester systemic corticosteroid use and oral clefts or decreased birth weight; however, information is conflicting and may be influenced by maternal dose/indication for use (Lunghi 2010; Park-Wyllie 2000; Pradat 2003). Hypoadrenalism may occur in newborns following maternal use of corticosteroids during pregnancy; monitor.
Because antenatal corticosteroid administration may reduce the incidence of intraventricular hemorrhage, necrotizing enterocolitis, neonatal mortality, and respiratory distress syndrome, the injection is often used for antenatal fetal lung maturation in patients with preterm premature rupture of membranes or preterm labor who are at risk of preterm delivery. A single course of Butenaskin BM is recommended for women between 24 and 34 weeks gestation who are at risk of delivering within 7 days, including those with ruptured membranes or multiple gestations. A single course of Butenaskin BM may be considered for women beginning at 23 weeks gestation, who are at risk of delivering within 7 days, in consultation with the family. In addition, a single course of Butenaskin BM may be given to women between 34 0/7 weeks and 36 6/7 weeks who are at risk of preterm delivery within 7 days and who have not previously received corticosteroids; use of concomitant tocolytics is not currently recommended and administration of late preterm corticosteroids has not been evaluated in women with intrauterine infection, multiple gestations, pregestational diabetes, or women who delivered previously by cesarean section at term. Multiple repeat courses are not recommended. However, in women with pregnancies less than 34 weeks gestation at risk for delivery within 7 days and who had a course of antenatal corticosteroids >14 days prior, a single repeat course may be considered; use of a repeat course in women with preterm prelabor rupture of membranes is controversial (ACOG 171 2016; ACOG 713 2017, ACOG 188 2018).
When systemic corticosteroids are needed in pregnancy for rheumatic disorders, it is generally recommended to use the lowest effective dose for the shortest duration of time, avoiding high doses during the first trimester. Intra-articular dosing may also be used during pregnancy (Götestam Skorpen 2016; Makol 2011; Østensen 2009).
There are no data on the excretion Butenaskin BM into human milk. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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