Corticosteroid — Obstetric and Gynaecological
Pregnancy: Used in specific obstetric indications; crosses placenta
Dexamethasone (Antenatal / OHSS / CAH)
Brand names: Dexamethasone (generic)
Adult dose
Dose: OHSS ascites drainage premedication: 8 mg IV single dose. CAH (congenital adrenal hyperplasia) — to suppress fetal androgen: 20 micrograms/kg/day in 3 divided doses (pre-implantation/early pregnancy)
Route: IV (OHSS) / Oral (CAH)
Frequency: Single dose (OHSS procedure); three times daily (CAH)
Max: Context-dependent
Note: betamethasone_antenatal (existing entry) covers fetal lung maturation. This entry covers dexamethasone in OHSS, HELLP syndrome (IV 10 mg every 6-12 hours), and nausea/vomiting
Paediatric dose
Dose: Not applicable in this obstetric context N/A/kg
Route: N/A
Frequency: N/A
Max: N/A
Maternal medication
Dose adjustments
Renal
No dose adjustment required
Hepatic
Use with caution in severe hepatic impairment
Paediatric weight-based calculator
Maternal medication
Clinical pearls
- HELLP syndrome: IV dexamethasone 10 mg every 6-12 hours improves platelet count, LFTs, and maternal condition — facilitates time for delivery planning; controversy remains about long-term benefit vs steroids
- PONV in obstetrics: dexamethasone 8 mg IV at induction reduces PONV at caesarean section — standard component of PONV prophylaxis with ondansetron
- CAH in pregnancy: maternal low-dose dexamethasone (crosses placenta) used investigationally to prevent virilisation of female fetuses at risk of classic CAH — only in specialist genetics centres; highly controversial
- Betamethasone preferred for fetal lung maturation (existing ID in this file) — dexamethasone covers the other obstetric indications listed here
- Gestational diabetes: steroids cause marked transient hyperglycaemia — extra glucose monitoring and insulin sliding scale required after antenatal steroid administration
Contraindications
- Systemic infection without antimicrobial cover
- Live vaccines
Side effects
- Hyperglycaemia
- Fluid retention
- Immunosuppression
- Psychiatric effects
Interactions
- NSAIDs (additive GI risk)
- Antidiabetics (raise blood glucose)
- Warfarin (variable INR effect)
Monitoring
- Blood glucose (post-dose monitoring)
- Blood pressure
- Platelet count and LFTs (HELLP context)
Reference: BNFc; BNF 90; RCOG Green-top 43 (HELLP); NICE NG25 (Antenatal Care); Magee et al. (HELLP corticosteroids). Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.