Steroid Shots?

MrsCaseyK

I'm not on this board. But I admire all of you and creep on here often and pray for all of you and your tiny ones.  

I'm 27 weeks with IC (cerclage at 21.6) and IU (lots of "BH" contractions, ugh) My question is there any reason why I shouldn't have steroid shots? My doc says he doesn't do them unless labor is imminent. But what if we don't have 48 hours from when I go in to when they are born...? I suppose I wouldn't have them every two weeks until they get here, but sometimes that does sound appealing. Any advice would be appreciated. I'll be talking to the doc a week from today and would be curious what you all had to say before we talk it over. 

When did you have them? How many rounds? Did it help? Or any other info you'd care to share...

Thank you, Thank you!

Cst2CstBride

Dd was born at 27 weeks and I got one 2 hours before she was born. I had severe preeclampsia that came in overnight so we didn't have anymore time. Dd was born breathing and crying. She was on CPAP for the pressure but did not need oxygen. I don't know if the shot helped. Preeclampsia stresses the baby and causes the lungs to rapidly develop so she could have done well because it was so severe or because of the shot.

I do think it is worth doing if there is a chance of early delivery.

PhillyGal34

I had one set 48 hours then 24 hours before induction. Ds was born at 31w5d due to severe pree with neurological symptoms. I had no warning but was fortunate enough to be able to be on hospital bed rest for almost 3 days before they induced me. Ds was born 1.5 days after the induction started so the steroids had time to work. He came out breathing and crying and only got oxygen by cannula for a few hours as a precaution. Like pp said, I'm not sure if it was the pree or the shots though.

Two questions I would ask are if the shots can cause problems if administered top frequently and if insurance would even cover them of delivery isn't imminent. Problem is that you don't know it's imminent until its too late some times.


Best of luck. Hope we don't see you back here [as in I hope you don't have a preemie!]

MinaE01

DS was born at 32w3d due to spontaneous PTL. I got one steroid shot about 2 hours before he was born. He was on CPAP for 24 hours breathing room air, and he didn't have any other breathing issues, thankfully. I like to think the steroid shot helped with that, even though it only had a few hours to take effect. Good luck! I hope they stay cooking for a couple more months!

kwells1

DS was born at 31 weeks due to spontaneous ptl.  I was able to get one steroid shot about 6 hours before he was born and he was born crying.  He did have breathing issues shortly after he got to the NICU, he was on a cpap, intubated with cerfactin (sp?) to develop his lungs, back to cpap then high flow nasal before being on room air.  His whole issue with breathing lasted about 2.5-3 weeks before he was on room air.  Good luck and hopefully those babies stay cooking for as long as possible!

mrsbnlmel

I was given both shots at 29 weeks when I developed blood pressure issues. I was told that would likely be delivering within a few days and that they are at their peak effectiveness in that time period. I very luckily ended up holding off delivery with strict bedrest until 35 weeks. DS did really well and only needed a little oxygen right after delivery. I was told, as pp's were, that part of that was probably due to my prolonged pre-e though. 

I did ask our MFM at the time and she said they only administer if they think delivery is highly likely within a week and that they don't recommend more than one course (2 shots) and occasionally 2 courses in a pregnancy. There isn't evidence that it helps and there was some research that shows it can inhibit other development since the body focuses the energy on maturing the lungs.

I think it sounds like your doctor is doing the same thing and probably feels you are stable for now. That's a great thing! Good luck.   

Mrs. Alice

There is really a short window in which the steroids are believed to be effective in assisting with fetal lung maturity.  From the research I've done, 7 days at most is the window.  "Boosters" or a 2nd round can be given if it's been over 2 weeks since the first round.  Multiple rounds is contraversial and studies are showing there can be negative effects with too many repeated rounds.  That can be why some Dr.'s are more conservative in the use of antenatal steroids. 

I had a round at 24 weeks when I had a high risk of delivery and then another round at 28 weeks completed right before they were born.  My boys both developed chronic lung disease in the NICU due to the time on ventilators and oxygen support.  However they don't have any lasting effects that we know from it and are very healthy now.  So I suppose it could have been worse and it could have been better.  It's hard to say.

If you're interested in some medical info about it these are good articles:

https://www.perinatology.com/protocols/Steroids.htm

 https://www.acog.org/Resources And Publications/Committee Opinions/Committee on Obstetric Practice/Antenatal Corticosteroid Therapy for Fetal Maturation.aspx

 

MrsCaseyK

This board is so much nicer than the "regular" pregnancy boards. Sometimes I think people who haven't been through tough stuff don't appreciate how important kind words and a shoulder to learn on are.

Thank you everyone! It actually really helped calm some of my fears. If they are trying to come early, hopefully we'll have enough time to get some in me and if not then I don't want any adverse side effects. And thanks for all your kind words, and I hope I don't have to come back. I don't know if I'm as strong as all you fine ladies! Prayers for all of you!

kuetgal

I just spoke to my doctor about this and can pass on what she told me.  With DD I delivered her at 33.5 weeks due to hbp and prom, I had 2 rounds of steroid shots and she came out screaming and only spent a short stay in the NICU before moving up.  So, with DS now I asked if I would be getting the shots again given my history, even though I am on the progesterone injections.  She told me the same thing you were told only if labor is imminent.  She said, and I don't fully understand this, that they only last a week so there is no point in giving them if delivery is  not a week away so they do the ffn test then determine if you need them.  Now, what I don't get is how they only work for a week, but that's another bag of worms.  Best of luck.

jacque_z

I didn't read the other replies.  Only once in my preemie travels have I heard of someone who wasn't at risk for imminent delivery getting preemptive steroid shots.   I got them them two hours before my daughter was born so not early enough to be effective.  GL to you!   

Pips09

I'm not well-versed on the science behind the steroid shots, but I think a couple of pp's have explained it well. I have heard the same; that they only work if you are going in to labor in the immediate future.

I had the shots when I was hospitalized at 27 weeks with contractions and bleeding. 2 rounds, 24 hours apart. They were able to get me under control and I was send home on modified bed rest. About 3 weeks later, I was back, and received a third shot. This time they were not able to stop my labor and I delivered just a few hours later, via emergency c-section. I like to think that they helped. My baby was born at 30w4d, and was on a CPAP for 2 days, then moved to a nasal cannula. 

punky917

I had pPROM at 24 weeks and had DS 2 weeks later. Luckily, I was able to get in the both steroid shots for that 1 round. I am sure that is it helpful. Unfortunately, DS caught pneumonia twice in the NICU and was on the vent for a long time. I am now almost 33 weeks with DD and with my history, they gave me a round of shots at 24 weeks. I have also been on bed rest since about 21.5 weeks for cervix shortening. MFM mentioned doing another round at 28 weeks, but when I had that appt, the other MFM didn't bring it up so I didn't either. Since I had been on bed rest for 7 weeks at that point with no signs of PTL, I didn't want steroids for no reason.

thishappyhouse

I was on hospital bedrest starting at 21w4d.  I was given steroids at 23w5d because I had no cervix left.  I had been "stable" for 2 weeks so delivery wasn't necessarily immanent.  I ended up delivering at 25w 0d.  I suppose if I had made it another week longer they may have considered another round.  

msyoon

I had my cerclarge at 17w and my water broke 2 weeks ago. I ended up getting the steroids shots and delivered 5 days later. The shots weren't bad but the magnesium IV they hooked me up, made me blow up and feel very high. Just something to watch out. I think the steroids helped my baby's development.

DrRx

I pPROM'd (they think a small tear or something since I didn't have a gush) around 21 weeks, but it wasn't discovered until 22w6d.  I was immediately admitted to the hospital from the ultrasound and was on hospital bedrest until I delivered.  I got the steroid shots around 24 weeks and my daughter was born at 26w2d. 

She was on a vent for 3 weeks and developed CLD (aka BPD), and did come home on oxygen, but she now has no lasting issues (she's 15-months old).  So, the shots may not have helped her lungs too much, but they also help with preventing brain bleeds (IVH).  My daughter didn't have any brain bleeds at all.  

I think that I remember reading that the reason they don't just routinely administer them or if they don't think that birth is imminent is that there is a higher risk of CP if too many steroids are administered.  I don't think that it was causative, just that it seemed to occur in those with multiple rounds vs. just 1 round.  

jcsntms06

With my first DD I got one shot, she was born 12 hours later. With my second DD I got both shots, one at 32w 6 and then one at 33w. I really think the shots helped, if anything to mature those preemie lungs.

Praying for you and your LO's. 

Nita14701

LO was a preemie due to pre-e/HELLP. I had 2 rounds (48 hours before and 12 hrs before). Although she was born at 28 weeks, size wise she was more like 26 weeks. She came out crying. I definately think the shots helped.

Mommy2CB

I went into PTL unexpectedly.. no warning whatsoever.. at 32w6d. I believe I recieved the 1st steroid shot the next morning, and the 2nd a day or 2 later? I know they had to be spread out over a certain amount of time. My DS1 was born a few days after that and spent 3wks in the NICU. He was onto on CPAP the very first night though and didn't really have any breathing problems after that.. it was mostly growing and learning to feed, and an allergy that set us back.

sdtchica13

I am personally still convinced my docs blew it. I was hospitalized for major bleeding at 29w, 3d and diagnosed with an abruption. I was kept overnight for monitoring and sent home, only to be back there the following day (29w, 5d) for more bleeding. I was not given a steroid shot until the following morning (29w, 6d) and went into labor that afternoon at 4PM, so there was no time for the second shot nor for the first one to have any effect.

While Corri came out screaming and breathing on her own, she was still on CPAP for 2 weeks and a cannula for almost another two. I am convinced if they had been a little more proactive and given the first shot when I went into the hospital the first time that week, we may have had less than a 9 week NICU stay and less time on breathing apparatus. 

I have been getting P17 shots this time around and have been watched a lot more closely, but if I end up in the hospital at all in the next 2-3 weeks, you better believe I will be pushing the docs to give the steroid shots immediately.  

LnR70707

I skimmed this post a few days ago, but couldn't add much because I was too far along (34w4days) with DS to get the shots, so the best we could do was participate in a blind study...which has naturally been suspended because of lack of funding so I still don't know if I got the steriods or the placebo with him but he needed no breathing assistance at all.

I got my first shot yesterday at 24w3days.  From skimming this post I asked about negative affects this early since my FFN was negative, but I didn't know enough to ask more questions, so now I'm wondering if the docs were blowing sunshine with their hopefulness that baby won't show in the next two weeks, or if they aren't as read up on studies as they should be.  Triage doc said they'd give a rescue shot if I made it beyond 2 weeks and found myselft in PTL again, but they did not like to give a 2nd whole round.