The use of corticosteroids in APS pregnancies is rare except for the treatment of maternal thrombocytopenia or co-existent SLE, for which prednisolone is still first line therapy. Regular blood glucose monitoring is required with long-term administration of steroids. Patients requiring >7.5 mg prednisolone daily for more than 2 weeks prior to delivery should be given intrapartum intravenous hydrocortisone 100 mg tds. Breast feeding is rarely contraindicated, although women taking 60 mg prednisolone with healthy term babies may consider bottle-feeding because of the theoretical risk of neonatal hypo-thalamic-pituitary adrenal suppression at these high doses.
Was this article helpful?