Please select the eligibility criteria that correspond to the clinical trial below.
Title: Rescue Antenatal Steroids and Lung Volumes in Preterm Infants
Brief Summary: One course of steroids given to a mother before a premature delivery helps the lungs of the premature infant and decreases breathing problems. One course of antenatal steroids is the standard of care for threatened premature deliveries. It is unclear as to how long the benefit of one course of steroids last. The most benefit to the baby's lungs seem to occur if the steroids are given at least 24 hours before but within 7 days of a premature delivery. It is difficult to predict the timing of a preterm delivery so deliveries often do not occur within this time period. We hypothesize that the benefits of the steroids to the lungs wear off if the steroids are given more than 14 days before a preterm delivery, and that in these circumstances an extra course of steroids will help the premature baby's lungs and the premature baby will have less breathing problems as shown by lung function testing.


Options:
A: Inclusion Criteria:

* (1) Age over 18 years
* (2) Twin pregnant women at 34weeks 0days to 36weeks 5days of gestation
* (3) At risk for preterm birth such as preterm labor, preterm prematrue rupture of membrane or maternal-fetal indications that need preterm delivery. Preterm labor is defined as regular uterine contractions with or without the following symptoms; pelvic pressure, backache, increased vaginal discharge, menstrual-like cramps, bleeding/show, cervical changes
* (4) Availability of written informed consent.

Exclusion Criteria:

* (1) Gestational age before 34weeks 0days or after 36weeks 6days
* (2) Lethal major fetal anomaly, fetal distress or fetal death in utero
* (3) Expected to deliver within 12 hours; for example, advanced cervical dilatation (\>8cm) in preterm labor or active phase labor (cervical dilatation\>4cm) in preterm premature rupture of membranes
* (4) History of a previous administration of ACS before 34weeks of gestation for fetal lung maturation
* (5) Administration of systemic steroid for medical indications
* (6)Diagnosis of clinical chorioamnionitis Fever \>37.8 and the presence of two more following conditions: uterine tenderness, foul-odored vaginal discharge, maternal leukocytosis(\>1500), maternal tachycardia(\>100) or fetal tachycardia(\>160)
B: This is an intent-to-treat design and thus all pregnancy outcomes of women who deliver in the study clusters and provide consent will be collected. Cluster-level inclusion criteria include

* At least 250 deliveries per year.
* Birth attendants within the health cluster will be consented to participate

Participant-level inclusion criteria include all pregnant women living in and delivering in the study cluster who:

* Are between 24 and 36 weeks GA;
* Present with signs of preterm labor, amniotic fluid leakage, hemorrhage, or hypertension;
* Provide consent for injection or present to a facility where it is standard of care.

Exclusion Criteria:

* There will not be any specific exclusion criteria for clusters or participants.
C: Inclusion Criteria:

* Greater than 14 days after first course of antenatal steroids;
* Less than 34 weeks of gestation;
* Identified by primary physician as continued risk for preterm delivery;
* Informed consent

Exclusion Criteria:

* Major congenital anomalies
* Multiple gestation of triplets or greater
* Mother with insulin dependent diabetes
D: Inclusion Criteria:

* Pregnancy between 34 and 36 weeks
* Confirmed gestational age (LMP, USG)
* Alive fetus
* Imminent risk of preterm delivery

Exclusion Criteria:

* Multiple pregnancy
* Major fetal malformations
* Comproved fetal lung maturity
* Maternal or fetal indication for immediate interruption of pregnancy
* Maternal hemorrhagic syndromes (placenta previa, abruptio placenta)
* Chorioamnionitis
* Chronic use of corticosteroids
* Previous use of corticosteroids for fetal lung maturation in the current pregnancy

Answer: C