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Preemies
Steroid shots for lungs - any reason NOT to get them?
Hi ladies,
Background... I'm thrilled to be 30w5d weeks with di-di twins. High risk pregnancy for 100 reasons (theirs and mine) and our son ("Cricket") may not survive much past birth due to some urinary anomolies, and other issues. Docs are pessimistic, this momma is gonna HOPE.
Cricket, our son that's ill.... recently showed us that his placenta is starting to fail. ("UAR") The profusion of the placenta was normal at 50% about 4 weeks ago, and then our scan last week showed it up to 95%. We check again to see how it's doing tomorrow. Docs says it could stay the same, get worse, get better. We have to talk about whether we take the babies early if HE's in trouble, or steer the course and just hope our daughter cooks more and comes out ok down the road.
The doc didn't say anything about doing the steroid shots for their/her lungs, I thought of it after. I'm reading there's a window that's BEST to do them, if you can choose, and that window is now.
QUESTION: Any reason to NOT do them? Those who had a chance to decide this ahead of time, what did you learn about this? I'm reading crud here and there about how it causes "delays" in kids down the road, etc. and worried that doing them prophylactically is not warranted, just do them when/if chit hits the fan?
Of course this on the top of my list to discuss with my peri tomorrow. Just thought I'd pick your brains about it too.
ps - She's measuring a full week ahead, he's always been a week+ behind. (but both are doing "practice breathing" and get the hiccups, FWIW. And again, he's been labeled "likely terminal" at many points in this pregnancy, but now, with the exception of this UAR thing, and the lack of evidence to support good function with his kidney(s), he seems to be doing "well" all things considered.)
Thanks so much.
Join us - Commit Random Acts of Kindness, and say
"I did it for Cricket"
This discussion has been closed.
Re: Steroid shots for lungs - any reason NOT to get them?
First, woohoo for 31 weeks!
I thought that research has shown no delays from the steriod shots pre-birth? I know recent research has reconfirmed that steriods - like decadron - given to micros and others for lung function after birth does potentially cause delays, but not the ones that you would get.
I guess I would just confirm with Dr. that if chit does hit the fan, how much time would you have (I really know nothing about UAR), and would that be enough time to get both doses in? From what I remember as well, they only do the steriods up to a certain GA - maybe 34 weeks? So, you are almost there. Hang in there, cricket!
Hi,
Like many ladies you'll find on here, I didn't have much of a choice re: the shots. I was sent to the hospital from a regular appointment, and they immediately started them. I ended up being able to bake my LO for another 7 weeks, but better safe than sorry. No side effects were discussed with me to be honest, and I never had any doubts that, if there were any possible, the benefits far outweighed them. Having a preemie with respiratory distress is not something to mess around with.
My LO was born at 35 weeks and even then he was labeled as having 'mild respiratory problems' for the first 48 hours after birth because his breathing rate was high at times. So, especially if one of your LO's is small and maybe weak in other ways, I'd want the shots.
It's my understanding that 28-32 weeks is considered the ideal week. They usually aren't given after 34 weeks. HTH and GL!!!
This exactly...
Our twins were born at 26 weeks...and we got steriod shots just days before they were born (we had no clue at that point when they would arrive). Hands down I think it made a huge impact of how well they did in the NICU. DS faired much much better then DD...we were told she wouldn't survive.
They both turned 1 today! They are on track for their adjusted age and in some areas "ahead" of the game. DD also had to use steriods after delivery on two seperate occasions to get off the vent because of other complications. We were explained at the time that "it is hard to confirm if the delays are linked to the steriods or simply because they are preemies, not many people want to be in the control group of not using the steriods because their benefits greatly outway their risks."
FWIW if I had to do it all over again, we would still do the steriod shots to help lung maturity in utero.
Thank you everyone for your advice and stories. I knew I wouldn't find a ton of ladies that had time to think about this prior, but I just felt funny walking into the appt tomorrow with only my peri's opinion to consider.
I just don't see any reason to NOT do them at this point. Regardless how that little boy does, his sister won't get much past 36-37 weeks. (long story, lots of issues besides his)
A special thinks to "Curlingrocks" - I'm sorry for the loss of your daughter. You've got it right - it's really hard being so fricken excited for (what's presumed) healthy baby, while dealing with all the issues with the other. BUT... we've prepared for the worst, now I just sit here and bake and hope for the best ;-) (whatever that is)
Many thanks again, I really appreciate it.
Wanted to add my 2c. I was observed for PTL at 27 weeks for 48hrs. I was contracting like crazy, but wasn't changing my cervix, so they told me they thought it was a whole lot of nothing. They offered med steroids saying, "we'd feel stupid if the pediatrician's kid was born preemie and without getting beta." I asked and they said there were no known risks to getting them,
I went into full blown PTL 2 wks later and Henry was born at 29w4d. He spent 18hr on the vent and 36 hrs on CPAP. As a pedi, I can say that I've first hand seen what a difference betamethasone can make for a preemie. I also feel as a mom that it made a big difference for my little guy. Unless there's a clear reason why not to, I say get the steroids!
BFP#2 3/16/11, beta 138; 4/12 Baby/HB DS born 9/10/11 at 29w4d due to partial abruption and PTL
BFP#3 8/19/13 Another boy! 17P, modified bedrest and Nifedipine helped us have a termie! DS2 born 4/19/14 at 38w5d.
Peanut Butter and Jelly!
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I did not get the steroid shots and when DS was born he had respiratory distress syndrome for 5 days and transient tachypnea of the newborn for over 72 hours. If I was given the opportunity to have it I would have.
Good luck and keep us updated.
BPF May 12, 2013 :: EDD Janaury 22, 2013 :: MC Began On July 14, 2013 at 12W4D
Born at 34w2d:
I had steroid shots around 29 weeks for IUGR, compromised cord blood flow, and oligohydramnios (oligo dx'd at 21 weeks). MFM actually held off giving me steroids for DS because of me being a Type 1 diabetic. But once IUGR and compromised cord blood flow were on the radar at 29 weeks, they wanted steroids on board.
Like most posters, I didn't have time to think about getting the steroids, as they thought I may deliver that week. But I ended up making it to 35 weeks. DS spent just one day in the NICU for hypoglycemia. He came out screaming and so his lungs were just fine.
I know MFM had told me that once you get to 34 weeks, that giving steroids is a moot point basically because you're close to term at that point. But who knows. I wasn't told of any negative side effects for baby with getting steroids.
Hugs and thinking of you and your LOs.
quik update: scan today said UAR cord/placenta profusion issue is now NORMAL. Whew! They'll keep watching it, but this is a most welcome relief, for now. One less thing to freak about.
Everything else is quiet and "good".... so when I asked the doc about getting the steroid shots, she said she'd like to hold out for another week, and talk again next week. Says THEY (the practice) believes the week before birth is a better window than the 28-32 one. Hint of trouble? Do them, and get the 2nd in 12 hrs prior to birth. I didn't see the point in pushing for them TODAY, but I'm still going to push for them if trouble brews again. (If I go into labor prior to our Master Plan (lol, because we're in charge? ha!) then we have to stall labor for other reasons anyways, if possible, so I'll buy what she's selling for now. They seem to be a pretty conservative practice, but they DO listen to me, and I trust them.
Thanks again ladies!
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I got them with my first pregnancy when my cervix was measuring around 1.5cm long at 30 weeks. She was born at 35w4d and went home with us (no NICU time).
Second pregnancy I was on P-17 and had a few other measures to keep my cervical length longer. At 30 weeks my cervix was much better at 2.5cm but I still got the steroids as a precaution. I ended up going full term, but for me (and my doctors) it was a "better safe than sorry" kind of deal.
Both of my kids are perfectly healthy.
Married 6/28/03
Kate ~ 7/3/09 *** Connor ~ 11/11/10
4 miscarriages: 2007, 2009, 2013, 2014
*~*~*~*~*
No more TTC for us. We are done, and at peace, as a family of 4.
"Suffering has been stronger than all other teaching, and has taught me to understand what your heart used to be. I have been bent and broken, but – I hope – into a better shape.” — Charles Dickens
I wasn't able to get the shot with my oldest and she ended up having a few breathing issues (CPAP), but since she was a 34 weeker, I think she did okay.
I was expecting preemies when I found out I was having twins (just because of previous PTL and HR twins), so was able to do a little research. My OB originally told me I would be able to get the prophalytic steroid shots to prevent PTL, but my MFM doc told me it didn't help with twins, so I wouldn't get them. Those are the steroids I read about causing harm in the long run, but the research is limited and I don't think anything has been proven. I think the school of thought is that it's better to take the chance with the steroids, than to have a preemie with complications.
As far as the steroids you get for lung developlment, I don't think they have shown any negative outcomes. I was able to get them for the twins, and at 33 weeks, they had no breathing problems, so they definitely helped. I'm glad I was able to get them this time!
I'm so sorry to hear about your struggle. I will be thinking about you and your sweet babies.