32 weeks with PTL- steroids question

meggiejo · January 2012

My 2nd son was born at 36 weeks after PTL for 4 weeks, he spent 5 days in the NICU with breathing difficulties. This pregnancy I've been doing progesterone shots weekly since 16 weeks. They have also been monitoring my cervical length. At 24 weeks my cervix was 4+cm, so they were happy. At 30w5d I was sent to triage for contractions and they determined my cervix was dynamic and got measurements between 2.4 and 4cm. I also had a positive FFN, so they said to rest and they would recheck in a week, but since my contractions had stopped they didn't feel I was in immediate risk of delivery. Last week- 31w5d- I was a solid 2cm so they put me on bedrest. Here is where I'm confused. At each of these appointments they have debated giving me steroids for lung development, but decided to wait. They keep saying they can't do any harm, and do so much good if he arrives early. So why would they not just go ahead with the shots? Do they only work for a certain time frame? My doctor said they only do the shots until 34 weeks, when they feel they don't do much on terms of aiding lung development. They said to go to triage for anything as tiny as a change in discharge to start the shots since it's 2 shots spaced out, but why delay until something is happening? I'm going to talk to my regular peri Thursday, but was just curious from a preemie mom's perspective if I need to insist on getting the shots if my scan shows any change at all in my cervix this week. TIA!

KatFCo · January 2012

The steriods work best when given as close to delivery as possible and they can only give the baby one round, so if they give the shot too early, it might not do as much good as if they had waited until birth was definite.

meggiejo · January 2012

Thanks for that information! I've just been so confused on why they debate it, but don't actually go ahead. My middle guy was born at 36 weeks with PROM, so that's why I was scared to wait, because they said they would have me deliver mediately at this point if my water broke. That would mean they possibly couldn't get in both shots.

KatFCo · January 2012

I delivered at 23w6d last time due to PTL so this time they're keeping a close eye on me. Everything looks fine now, but my doctor's keeping a close eye on me for the same reason: as soon as it looks like I'm going to deliver, she's starting me on the steriods.

Good luck!

CPhillz · January 2012

I haven't yet delivered, but last week (26 wks) I went into L&D with contractions, and then got a positive FFN. My doctor gave me the steroids last week. Her words, "If I even have to THINK about giving steroids, then thats a good indication that we should go ahead and do them." She said it can't hurt, only do good for the baby. I'm not dilated or thinning yet either, but I'm glad we went ahead and did them.

KatFCo · January 2012

LegalPawn:

KatFCo:
The steriods work best when given as close to delivery as possible and they can only give the baby one round, so if they give the shot too early, it might not do as much good as if they had waited until birth was definite.

Not true. I had two rounds of the shot. One at 29 weeks and one at 33 weeks. The shots are only effective for 2 weeks, so the ones I received at 29 weeks had worn off.

Thanks for correcting me. I may have misunderstood my OB.

HJOHNSTON411 · January 2012

My Dr also will do two rounds of shots. The shots must be given over 24 hours, and I think they take 48 hours to have maximum effect (*think* that's what they told me). Regardless, as PP said, my Dr said if prior to 32 weeks he even thought about me needing the shots, he was giving them. I think they are most effective within a week or two time frame, and can be given again. I got my first set at 28 weeks and was told at my 31 week appt that if it looked like I would deliver before 34 weeks, they'd probably do another round.

I have two friends who went into labor early, Drs tried to give first shot and hold them off, but they progressed too quickly and babies were born before the second shot. Not to scare you by any means, but that's why I agree with my Dr's philosophy that it can't hurt to go ahead and get them if there is any question.

GL!!!

jcsntms06 · January 2012

HJOHNSTON411:
My Dr also will do two rounds of shots. The shots must be given over 24 hours, and I think they take 48 hours to have maximum effect (*think* that's what they told me). Regardless, as PP said, my Dr said if prior to 32 weeks he even thought about me needing the shots, he was giving them. I think they are most effective within a week or two time frame, and can be given again. I got my first set at 28 weeks and was told at my 31 week appt that if it looked like I would deliver before 34 weeks, they'd probably do another round.
I have two friends who went into labor early, Drs tried to give first shot and hold them off, but they progressed too quickly and babies were born before the second shot. Not to scare you by any means, but that's why I agree with my Dr's philosophy that it can't hurt to go ahead and get them if there is any question.
GL!!!

I only received one steroid shot before my DD was born. She was born at 33weeks. My water broke and my labor progressed quite quickly. My DD was born exactly 12 hours after my 1st shot.

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