Prophylactic Steroids

SV917

I had my regular OB appointment today and my doctor offered me steroids "just in case" the twins are born premature. So far, this pregnancy has gone relatively smoothly. (I'm 33 weeks & 4 days for those on mobile). My cervix is long and closed; I haven't been put on bedrest, but it's twins so things could change very quickly, of course. I could go into premature labor next week or I could make it to my scheduled c-section date of October 18th. I've never heard of steroids being given prophylactically. Steroids seem like a pretty big deal without there being any immediate need, so my initial reaction is no. My doctor said it's my call, so I was just wondering if anyone did this and had a good or bad experience with it.

carrotcake06

I could be wrong, but I'm pretty sure steroids are only offered up until 34w. I don't know how long they last, though.

I received steroids at 32w as a precaution but I did have a dx of (very) mild pre-e. basically I was told there is no downside. I was also told that the shots I would receive would take me to 34w, at which they are no longer recommended.

Fwiw, my water broke at 34w and both babies needed zero breathing assistance and had a short, uneventful 13 day NICU stay as feeders and growers.

SV917

Yes, 34 weeks is the cut off, so I have to decide tomorrow. It's great that your babies needed no breathing assistance, carrotcake. Did they tell you the benefit of the shots only went to 34 weeks? Because if that's true, there's no point in getting them at almost 34 weeks.

My doctor also said that there are no side effects; I just have a hard time believing that. I pumped myself full of hormones for IVF, not sure why I am struggling with this.

chickaboo1974

I didn't get steroids- I had high BP at 31 weeks- diagnosed with pre-e at 34 weeks and my boys were born at 34 w 3 d. My guys needed no breathing assistance- they were in the NICU for 17 days only to learn to eat- which is something that you can't hurry along. 

LegallyBlonde217

My water ruptured at 30 weeks, and I got the steroids the day I was admitted to the hospital and the day after.  I delivered my twins at 33w4d, and both of them were born breathing room air.  Neither ever needed any assistance breathing while they were in the NICU.  I'm convinced it was thanks to the steroids.  So, I would definitely get them if they were offered to me!  The only side effects I had was inability to sleep for those 2 nights.  Steroids always make me kind of hyper like that.  It's a common s/e of them.

carrotcake06

@sv917, the dr said their effectiveness would last from when I got them at 32w to 34w, at which point I wouldn't be eligible for them anymore. I guess the point of that being I wouldn't need more than one round regardless.

I would ask what your dr's take on how long they'd be effective / you could see the benefits if you got them at 34w. From my limited knowledge, there is a lot of variability in those late pre-term weeks.

I'd also ask that they be done outpatient. I don't know what's standard but I was in the hospital m between injections and that blew big time. Oh! and would your insurance cover them without an underlying diagnosis of anything more than a twin pg? Idk if that makes a difference, but I'm STILL receiving $15k bills for their NICU stay when that's clearly not what I owe.

TREDgirl

I got the shot at 32 weeks as I was having some mild contractions and slightly elevated BP. I figured it couldn't hurt. I had also been having a great, no complications pregnancy but they were worried that I may go into pre-term labor. I figured anything that may help was worth doing. 

Missa_g

Steroid shots are most effective in the one week after they are given. At 34w and no impending delivery I would really consider it, but I have never been in that situation. I received the shots at 28w1d and a second dose 24 hours later. I had no side effects and my boys still required O2 support for the first several weeks after being born at 29w4d. But the O2 support was significantly less than "normal" for that gestation. It's a very personal choice. With my NICU experience I would likely choose to get them because they won't hurt and they might help.

SV917

Thanks everyone. I guess I need to ask my OB what the benefit after 34 weeks is. I feel like if I was any earlier or if I was having any mild indication of preterm labor, there would not be any question about getting the shot.

pea-kay

I got mine at 32w and when they were born at 33w2d, they needed no breathing assistance. I definitely credit the steroids for that. But you're already further along than I was when I delivered, so hopefully you'll make it far enough that it won't be an issue. But if I were you, I'd get them. I never had any PTL, but pre-e got me pretty fast (as you can see.)

pizzo84

My twins were a couple weeks earlier (32wks 1 day when they were born), I received my second dose of steroids 1 week prior to their delivery and they still required ventilator support for a few days and oxygen for a few weeks. You really never know how things are going to turn out. I'm not sure how things would have turned out if I hadn't had the steroid shots! Good luck on your decision.

staceymack

I received the first dose the day I turned 24 weeks as recommended by our perinatologist. We were facing several potential complications. Luckily, we were able to hold out until 33w 4d. Baby A needed no breathing assistance, and baby B only needed 1L/min O2 via nasal cannula for less than 24 hours. They both came into the world screaming their heads off! Everyone was talking about what a great set of lungs they have.