Prednisolone

• Hyperemesis (refractory)
• Asthma exacerbation
• Autoimmune flare (SLE, IBD)

Glucocorticoid receptor → ↓ inflammatory gene transcription.

• Prednisolone — maternal (90% inactivated by placental 11β-HSD2)
• Betamethasone — fetal (lung maturation)

Hyperemesis

40–50 mg PO OD, taper

Asthma exac

40 mg PO OD ×5 days

• CautionGDM (worsens), infection, peptic ulcer

• Hyperglycaemia, weight gain, mood, ↑ infection
• Cleft lip/palate risk T1 (small)

• • ~10% reaches fetus.
• • Compatible with BF (delay BF 4 h if dose >40 mg).

• NSAIDs

  Caution

  GI bleed

• Live vaccines

  Avoid

  Avoid

• 💡 Doses <20 mg/day are considered optimal in pregnancy — higher doses carry a small ↑ risk of oral cleft, preterm birth, and low birth weight.
• 💡 Lowest effective dose; monitor glucose.
• 💡 Stress-dose at delivery if long-term.