Effect of antenatal Dexamethasone therapy on maternal blood glucose levels and fetal well being

This study will be conducted in the Department of Obstetrics and Gynecology at Government Medical College and Hospital Chandigarh, focusing on pregnant women between 26-34 weeks of gestation with pre-term labor pains, premature rupture of membranes, and those who need cesarean section. Antenatal women will be recruited after informed consent and ethical clearance from the Institutional Ethics Committee. The study is a prospective observational study, with a sample size calculated based on 95% nondiabetic on glucocorticosteroids showing an increase in blood glucose levels above 140 mg/dl. The study includes pregnant women without diabetes and those planned for lower segment cesarean section (LSCS). Exclusion criteria include pregnant women with pre-existing diabetes and gestational diabetes mellitus, fetal growth restriction, patients requiring immediate termination of pregnancy or in established preterm labor, pregnant women with evidence of infection, chronic kidney disease, pre-existing adrenal and pancreatic dysfunction, tocolysis with beta-mimetic agents, and multifetal gestation. All patients visiting gynecological OPD and admitted to the labor room with the inclusion criteria will be enrolled after informed consent. Detailed demographic details, antenatal previous obstetrics, and medical history will be taken. A baseline general examination and obstetrical examination will be done before recruitment into the study. Routine blood samples will be taken, including complete blood count, renal function test, liver function test, c-reactive protein, and a vaginal swab for culture sensitivity if indicated. To exclude diabetes, random blood sugar will be tested in all recruited patients before starting Dexamethasone injection. Patients with a normal 75 gm glucose tolerance test (GTT) done between 24-28 weeks of gestation are included in the study. Dexamethasone dosage administration will be in the form of four doses of 6 mg separated by 12 hours intramuscularly. Baseline fetal movement count, nonstress test, biophysical profile, and umbilical artery Doppler flow will be studied before the administration of corticosteroid therapy.