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Steroid injection for fetal lung development

post #1 of 25
Thread Starter 
At my OB appt. today, my ultra conservative OB said she want me to have 2 steroid injections - one straight after the appt and one tomorrow.

She said if the baby does come early it'll just make sure his lungs are developed properly. She said in my situation where that could happen, it's recommended because if I go into hospital and need emergency heart surgery, they won't be able to give me steroids then because they take 48 hours to work, and my heart wouldn't last that long. But... my heart condition has been completely stable for the last 2 years, isn't at a critical state (or near it), hasn't changed throughout the pregnancy, and isn't likely to dramatically change in the next 11 or so weeks when he's due.

I don't particularly want to get steroid injections if I don't need them. She said they can't force me, so we said we'd like to do our own research tonight, then make up our own minds, then start tomorrow if we decide to do it.

We asked about side effects and she said "oh there really isn't any", but wouldn't elaborate. I don't fully trust this OB - like I said she's ultra conservative.

Does anyone know about the steroid injections that help lung development in fetuses, and if there's any side effects - particularly if the baby isn't born for another 11 or so weeks?

We're about to go Googling, but any first hand knowledge is appreciated!

Thanks
post #2 of 25
i dont have any advice here, to give.
i would not think a steroid injection would have much effect in the bad way.

But like you said, a little research first is not a bad idea.
Good luck
post #3 of 25
All I can tell you (which doesn't apply in your case) is that if she is referring to Betamethazone, as I think she is, this was so important with our pre-termers..getting the two shots in made a real difference back when I was working, which was up until 1995. Now, granted I expect they've made some changes in protocol and in understanding how best to deal with pre-term babies.

I did a lot of antepartum care as well as intensive care (constant monitoring of mom and unborn baby) of high risk moms.

I am sure you will be able to find information with your google search, and that you know how to find the gold info amidst the chaff
post #4 of 25
I don't know a great deal about Labour and Delivery, but I have worked in the Antipartum area.

I do know that babies who are born prematurely whose mother received steriod injections prior to delivery stand a better chance of survival, infact a 50% better chance of survival than babies who are born premature whose mother didn't receive the steroid injections.

A potential (not a given) side effect of the steroids for the mother is a mild resistance to insulin, but only temporary. Another symptom is an increase in your appetite.

The other alternative to you not receiving steroids would be for your baby to receive them after the birth.

Since they have started to give the Mom steroid injections before the 34th week, very few babies have to receive the injections after they are born.

My suggestion is that you go ahead with the injections. It really could mean the life of your child in the event of a premature birth.

Here is an article I found:

http://query.nytimes.com/gst/fullpag...50C0A962958260
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post #5 of 25
My sister had steriod injections when she was pregnant with my neice for the same reason.
To my knowledge, Samantha was born a happy healthy baby @ a little over 7lbs. She wa born early too

I would maybe call some neonatologists too
post #6 of 25
My water broke 7 weeks early and I was given those injections. My daughter ended up being born 5 weeks early and healthy.
post #7 of 25
Thread Starter 
Thanks very much guys!! I don't really think it's necessary for me to have it, but if there's no major side effects, then I guess it can't hurt. We actually didn't have much luck with our Google search, which I guess means there's been no major problems with it. I just feel weird about getting injected with steroids...

And Pat - yes, it's Betamethasone.
post #8 of 25
Quote:
Originally Posted by sarahp View Post
Thanks very much guys!! I don't really think it's necessary for me to have it, but if there's no major side effects, then I guess it can't hurt. We actually didn't have much luck with our Google search, which I guess means there's been no major problems with it. I just feel weird about getting injected with steroids...

And Pat - yes, it's Betamethasone.
You know my only excuse for what I'm about to say is I'm really distracted with dealing with my knee issues...duh...I have a dear friend who I worked with on this high risk labor and delivery unit years ago, who went on to become a midwife. I'll zip her a note and ask re potential side effects, any online articles she may know of that I can refer you to
post #9 of 25
I don't know much personally in that issue but when I was preggo I used to watch the pregnancy shows on the Discovery Health channel all the time. Many women had to receive those shots but they all turned out fine and both mom and child were healthy. I would suggest watching them if you can but then again, some of the shows might scare you since they involved some of the most severe cases. I have a pretty tough mind towards that so it didn't faze me but teach me what can go wrong and how the doctors cope with it.
All in all, just remember that everything will be fine and it will be so. Good luck to you!
Curious question though, have they approximated how big your baby might be when it's born?
post #10 of 25
Quote:
Originally Posted by sarahp View Post
Thanks very much guys!! I don't really think it's necessary for me to have it, but if there's no major side effects, then I guess it can't hurt. We actually didn't have much luck with our Google search, which I guess means there's been no major problems with it. I just feel weird about getting injected with steroids...

And Pat - yes, it's Betamethasone.
It is quite routine if there is a chance the baby might be born early. I don't believe there are any major side effects. When I was doing my OB rotation, the main issue was whether or not the mom had time to get the 2 injections before delivery, if she was going to be early (e.g. emergency preterm labor cases).

Steroids (e.g. betamethasone & dexamethasone) are commonly used if the baby is expected early b/c the steroids can help facilitate fetal respiratory/lung development. When a baby is born too young, it hasn't had enough time to produce adequate surfactant to help inflate the air sacs in its lungs -- and this can cause fetal respiratory distress, which can be quite serious.

Here's a nice article from webmd regarding the topic: http://www.webmd.com/baby/Antenatal-...ng-development

Good luck on your pregnancy!
post #11 of 25
Here's the thing -- if you don't have the injections and something goes wrong with your baby, you'd never stop blaming yourself. Unless your research turns up some serious, credible reason not to, I'd go ahead with it.

And here's today's batch of safe-pregnancy-healthy-baby vibes:
post #12 of 25
Thread Starter 
Thanks guys, you all rock

Quote:
Originally Posted by StacyD1987 View Post
Curious question though, have they approximated how big your baby might be when it's born?
Nope, but at my last growth ultrasound he was measuring right on schedule. At almost 27 weeks they estimated he was weighing 2lbs 1oz.

Quote:
Originally Posted by CarolPetunia View Post
Here's the thing -- if you don't have the injections and something goes wrong with your baby, you'd never stop blaming yourself. Unless your research turns up some serious, credible reason not to, I'd go ahead with it.

And here's today's batch of safe-pregnancy-healthy-baby vibes:
I can't find anything saying it can have bad side effects so far, and you're right - I'd never forgive myself if he WAS born early!

So I guess I'll be keeping my appointment today. In 2 1/2 hours I'm going to be injected with 'roids!
post #13 of 25
Quote:
Originally Posted by sarahp View Post
Thanks guys, you all rock



Nope, but at my last growth ultrasound he was measuring right on schedule. At almost 27 weeks they estimated he was weighing 2lbs 1oz.



I can't find anything saying it can have bad side effects so far, and you're right - I'd never forgive myself if he WAS born early!

So I guess I'll be keeping my appointment today. In 2 1/2 hours I'm going to be injected with 'roids!
Yay for 'roids! Good luck! Glad to hear that he's measuring good. I just hope he doesn't get too big, lol. The boy I surrogated was 9lbs 8 ounces, 22ish inches long. The docs said it was because of all the milk I was drinking! Lol.
post #14 of 25
Thread Starter 
Quote:
Originally Posted by StacyD1987 View Post
Yay for 'roids! Good luck! Glad to hear that he's measuring good. I just hope he doesn't get too big, lol. The boy I surrogated was 9lbs 8 ounces, 22ish inches long. The docs said it was because of all the milk I was drinking! Lol.
Whew, that's a big baby!!!!!! Lucky you
post #15 of 25
Quote:
Originally Posted by StacyD1987 View Post
The boy I surrogated was 9lbs 8 ounces, 22ish inches long.
When my Sister-in-law was pregnant with my youngest nephew she was huge! When she went into labour and was taken to the hospital they thought she was having twins because of her size. Ryan turned out to be 10 lbs 11 1/2 ounces. He held his head up from birth! LOL
post #16 of 25
Quote:
Originally Posted by sarahp View Post
Whew, that's a big baby!!!!!! Lucky you
Lucky?! I had a 3rd degree tear! Lol. It healed quite well though so no need to worry about yourself tearing.
Quote:
Originally Posted by Natalie_ca View Post
When my Sister-in-law was pregnant with my youngest nephew she was huge! When she went into labour and was taken to the hospital they thought she was having twins because of her size. Ryan turned out to be 10 lbs 11 1/2 ounces. He held his head up from birth! LOL
Lol, Dane, the boy, did that same thing! Strong kids!
post #17 of 25
Thread Starter 
Well I'm all 'roided up now. And what a frustrating experience!!!

My appointment was at 1pm, and they said to call ahead just to make sure they had the Betamethasone in, because otherwise they had to order it from the pharmacy and go collect it from the hospital (which is across the road). So i called at 12:15 and asked if they had it, and the lady said no, but she'd get it ordered in for me, but the nurses were on lunch, so it would take about 45 mins.

I said, well how about I come in at 2pm instead to give them time to finish lunch and get the stuff ordered in, and she said that would be great.

So I turned up at 2, and they couldn't find my file, they didn't know I was coming in and it was all a mess. I told them how I'd called up 2 hours before and organised it all and they were still confused...

So anyway, I finally got called into the nurse and they took my weight and blood pressure, then said to wait for the other nurse to come get me. That nurse came and said that they had to order in the stuff, so it would take up to an hour before they got it!!

I told her how I had an appointment at 1pm (which I only made at 4:30 yesterday) SPECIFICALLY to come in for this injection, and how I'd called up to make sure they had it, and was told they'd get it organised to get it in, and I'd be here at 2 for the shot. She was very apologetic and said that next time to ask to speak to one of the nurses because the front desk staff weren't the best. How is that my problem?!?!?!?! If the front desk staff are too busy to remember to order this stuff in they shouldn't be handling those calls in the first place!!!!!

I was SO annoyed! She said she'd get it rushed over, but 30 minutes was the fastest they'd be able to get it in, and she'd see what she could do.

I didn't really have a choice - I wasn't going to just go away since I'd already driven out there and waited a while. So I went back to the waiting room and waited another 40 minutes until they called me, and she gave me the injection. And not only was the injection painful, but it took ages to inject - a good 30-40 seconds I reckon and HURT!

By this time it was about 3:15 I guess. I confirmed that when I came in for tomorrow's appointment at 1pm they would have the stuff to inject and she said yes, they would make sure of it. So then I finally left and was driving home and the nurse called me and said "oh I forgot to mention - you need to have the injections 24 hours apart". I said I knew, and I was coming in at 1 the next day. She said that they had to be 24 hours apart not 22 hours apart, so I had to come in at around 3 tomorrow, I couldn't come in at one.

My husband's big annual work summer picnic is tomorrow which is supposed to be so fun, and it starts at 2 - which is why I booked it in for 1pm Friday - so I could go straight there. So I'm SO mad right now. They completely stuffed me around, were in my opinion, very unprofessional about it, and not only wasted my time this afternoon, but are going to ruin tomorrow afternoon for me as well.

I think I'll just turn up at 2pm tomorrow, and be extra doubly sure they have the steroid, and just wait there and get it as soon as they'll give it to me. I'm also writing in a letter of complaint to the hospital to let them know how much they've inconvenienced me when I did everything I was supposed to.

I was so annoyed that on the way home I decided I needed Baskin Robbins ice cream. So I stopped off at a pharmacy, got some Lactese tablets (I'm lactose intolerant), then went to Baskin Robbins and scoffed some lactese tablets so I could have ice cream to feel better I got a scoop of choc chip cookie dough and a scoop of chocolate mud fudge or something like that which was so full of dark chocolately goodness!!!!
post #18 of 25
Ah chocolate and ice cream...so good at soothing away frustrations and stress.

I agree, they botched this big time. I hope your dh's picnic is a nice long affair, and that you still have a very good time!

ps thank you for my ladybug!
post #19 of 25
Mmm... you know the cheap chocolate ice-cream at Wal-Mart? Their own little wal-mart brand? Aaah, that stuff's even better than the more expensive ones! ^.^ Yum!
post #20 of 25
Quote:
Originally Posted by StacyD1987 View Post
Mmm... you know the cheap chocolate ice-cream at Wal-Mart? Their own little wal-mart brand? Aaah, that stuff's even better than the more expensive ones! ^.^ Yum!
hehehe! I've noticed that about other flavors before!!
post #21 of 25
If it were me, I would research. Then I would do whatever was in my power to try and help my baby and make sure i do whatever i think is in the baby's best interest. If it were me, (since i will most definitely be high risk when if i'm able to have kids) i would get the shots. If there was even the most remote chance it could help save my child from some of the complications of being born early such as inadequate lung development- it's worth it in my book..
post #22 of 25
Thread Starter 
Quote:
Originally Posted by StarryEyedTiGeR View Post
If it were me, I would research. Then I would do whatever was in my power to try and help my baby and make sure i do whatever i think is in the baby's best interest. If it were me, (since i will most definitely be high risk when if i'm able to have kids) i would get the shots. If there was even the most remote chance it could help save my child from some of the complications of being born early such as inadequate lung development- it's worth it in my book..
Yup, well I did go ahead and do it. My concern was what might it do for the baby if he was full term? Would there be any complications with him having fully developed lungs, but still sitting in my belly for another 11 weeks. I don't want to be injected with something like steroids until I'm fully informed! My doctor would say anything to get what she wants. She actually fibbed to me yesterday to try to get my to stay and have the injection straight away.
post #23 of 25
I'm sorry to hear you had such a frustrating time. Your plan for tomorrow is a good one! It will be worth it because you are putting up with all this for your little one.
post #24 of 25
Hopefully today goes better and you can make it to the picnic.
post #25 of 25
I give all kinds of medications to patients and 1 hour either way is no big deal As a matter of fact the hosptial I work at has a 2 hour either way policy for most medications except narcotics and antibiotics.
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