Fetal lung development

[toolie]

My wife is 27 weeks pregnant with twins and has been insulin dependant for 15 years. We have been working with a maternal and fetal care specialist during the entire pregnancy. The estimated weight of twin "A" is 1 lb 8oz and twin "B" is 1 lb 12 oz. For the past week her BP has been 140/90. She also gained 3 pounds this past week. The Dr. is concerned she may have preeclampsia. She just took a blood test and is starting a 24 hour urine test. The Dr. mentioned possibly admitting her to the hospital to control the preeclampsia and giving her steroids to help the lungs develop. Once she is taking steroids, how long does it take the lungs to develop so they can work properly? Do these steroids adversly affect blood sugars?

T. Carlson

[expert on call]

Steroids for accelerating fetal lung maturity are given as either two injections 24 hours apart (betamethasone), or 4-8 injections every 6-12 hours (dexamethasone). The betamethasone regimen is preferred. The maximum benefit for fetal lung maturation is seen 24 hours after the last dose is given and persists for at least 7 days. At present, repetitive dosing is not recommended. Corticosteroids at these doses will adversely affect blood sugar, but adjusting insulin dosage will control this and the fetal benefits tend outweigh the maternal metabolic risks. Blood glucose control will usually return to near baseline levels within 4-5 days.

As for preeclampsia, your wife has two major risk factors - twins, and insulin dependent diabetes, so I suspect that you doctor is correct in his concern regarding preeclampsia development.

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patient’s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.