Steroids for twin babies' lung maturation - Mothering Forums

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#1 of 11 Old 09-13-2005, 04:23 AM - Thread Starter
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I'm almost 27 weeks, and my doc wants to give me that steroid series this week. Seems fine....but i have had no signs of really needing it yet (in that there are no obvious reasons to believe they will be born early), but if there are no side effects or problems with it, i see no reason to avoid it.

Can anyone give me some advice on this???? Thanks!
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#2 of 11 Old 09-13-2005, 07:10 AM
 
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Hi You dont have any history of premature birth at all and he wants to give you steriods w/o any indication of PTL? From what I've read and head its pretty controversial to give the steriod series to anyone who isn't openly showing signs of PTL even for those whose history indicates it. Most doctors dont do it at all, was the reasoning twins? I did get the series at 24 wks because I delivered my singletons at 23 and 25 wks and we thought it was best. Thing is the steriods are most benifit if they get them within a week of delivery so if you dont go into labor many doctors will want to rescue dose you with another series if you do go into labor after that wk but before you are full term, rescue doseing at this point isn't "recommended" because of the increase risk of the steriods to your babies. Steriods given repeatly or in larger doses can cause issues to brain development, tho this obviously isn't long term but its more than they would of received therefore the risk of side effects is possibly increased. I am personally glad I did it, in my case I think the benefits outweighed the possible risks as being born at 23-26 wks carries a whole other set of issues, however I dont think its right for everyone. If I had no history of issues I wouldn't of done it personally. You can find some studies and articals on it online. Im going to see if I can find one for you. Here is one good one, long but maybe take a look (i dont know how to make a link) http://fn.bmjjournals.com/cgi/conten...83/2/F154#SEC3
Good luck to you
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#3 of 11 Old 09-13-2005, 10:29 AM
 
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I personally wouldn't get it just for the heck of it. I'd have to have a really good reason to believe the babies would be early enough to need it.
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#4 of 11 Old 09-13-2005, 11:00 AM
 
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Quote:
Originally Posted by amnesiac
I personally wouldn't get it just for the heck of it. I'd have to have a really good reason to believe the babies would be early enough to need it.
I totally agree.
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#5 of 11 Old 09-13-2005, 11:22 AM
 
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I had the steroid shots with my twins, but that was b/c I was showing signs of PTL. I can't understand why any doctor would want to give the shots if the momma was showing no signs of PTL. The shots are only effective if given around a week or so before birth...why give the shots if they are not needed???
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#6 of 11 Old 09-13-2005, 11:37 AM
 
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No way I'd do it without reason. Steroids are nasty.

-Angela
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#7 of 11 Old 09-13-2005, 11:52 AM
 
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I had the steriod shots at 31 weeks gestation. I had already had several preterm labor scares, so it was definately advisable for us to proceed with it. I delivered at 34 weeks.

If you haven't had any PTL, I would talk with your doc about why he thinks it's necessary.

Tracy
mama to Sam and Jack, 19 monts old
#3 edd 10/12/05
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#8 of 11 Old 09-13-2005, 01:56 PM
 
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I don't think any doc would say there are no risks with steroids. It's more of a balance of risks and benefits. I had the series at 26 weeks due to shortening cervical length. My understanding is that in addition to some issues with immune system depression in the newborn, there is also a slight risk of pulmonary hypertension in the mother, especially if she is also given tocolytic drugs.

I don't regret having taking the steroids, though I am now nearly at term and did not need them, but I would definitely not take them without good reason.

Another issue to keep in mind is blood sugar levels. I failed my 1 hr GTT and couldn't tolerate the 3 hour so I was checking my blood sugars at home. The steroids can elevate blood sugar levels for up to 2 weeks after getting the injections. I didn't realize this and actually lost weight during that time because it seemed like anything I ate increased my blood sugar and so I really cut back on carbs. Wish I had realized the true culprit.

Trying to get my bearings...
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#9 of 11 Old 09-13-2005, 04:51 PM
 
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Yeah, I'd say no way too!
Steriods do serve a purpose when needed. But to just give them "just because" is rediculous.
Joline
p.s. I had my babies at 40 weeks 1 day. THere is no reason to assume you will go early just because it is twins. Especially if you have no signs of ptl. (or any other issue which would cause a need for emergency c)
Joline
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#10 of 11 Old 09-15-2005, 11:23 AM - Thread Starter
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thank you twin mommies!

All I've read is a NIH consensus chapter on this topic, and the chapter agrees with what you are saying. This might sound weird -- and i think it's kind of bad that i'm saying this -- but i'm trying to pick my battles with this doctor. She's the best i could find, but she does have some weird things like this...

I'm getting an u/s tomorrow, then i plan to use those results to talk with her about whether the steroids still make sense. I think she's being very "conservative" (her word) with my care b/c i'm an American living in India and there's all this weirdness about wanting to prove that the care is up to date....meanwhile i think i'm a bit more well-read and clear about my wants than the average indian patient....so it's kind of complicated, you know?

Thanks a lot for your help!

Kiran
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#11 of 11 Old 09-16-2005, 01:45 AM
 
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Kir - totally ot but you didn't happen to live and work in Toronto in the early - mid 90s did you?

Oh - and I agree with everyone about the Steroids. I live in Canada and it was offered to me more in the manner of "this is something we could do if you feel you need it" so maybe your doctor is just covering her bases.

good luck with the appointment

Karen

Blessed partner to a great guy, and mama to 4 amazing kids. Unfortunate target of an irrationally angry IRL stalker.

Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else; you are the one who gets burned. ~ Buddha

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