European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

Among the new recommendations
1 Mothers at high risk of preterm birth < 28–30 weeks’ gestation
should be transferred to perinatal centres with experience
in management of RDS (C1).
2 Clinicians should offer a single course of prenatal corticosteroids
to all women at risk of preterm delivery from when
pregnancy is considered potentially viable until 34 weeks’
gestation ideally at least 24 h before birth (A1).
3 A single repeat course of steroids may be given in threatened
preterm birth before 32 weeks’ gestation if the first course
was administered at least 1–2 weeks earlier (A2).
4 MgSO4 should be administered to women in imminent labour
before 32 weeks’ gestation (A2).

5 In women with symptoms of preterm labour, cervical length
and fibronectin measurements should be considered to prevent
unnecessary use of tocolytic drugs and/or antenatal steroids
(B2).
6 Clinicians should consider short-term use of tocolytic drugs
in very preterm pregnancies to allow completion of a course
of corticosteroids and/or in utero transfer to a perinatal centre
(B1).