Steroid Shot ??'s

[caryn]

I've heard "not past 34 weeks" -- the neonatologists were pleased on admission that I was at 33 weeks 5 days and so I could get the series of two shots -- and DS spent only a week in NICU after he was sectioned out at 34 weeks on the nose.

That's all anedcotal, and 5 years old to boot, so I'll go look in Pubmed and see what I can see. [:)]

ETA: here we are! And yeah, they don't actually know for sure.

Although antenatal glucocorticoids are standard of care for women at risk of preterm delivery before 32 to 34 weeks' gestation, the choice and dosing of the corticosteroid has not been standardized.

http://tinyurl.com/3y9rna

[michellelhuston]

I received 2 shots 24 hours apart with this last pregnancy at 28 weeks just in case of an early delivery. My doctor said that it would not hurt to have them. I have heard that they really are not effective if you receive them past 32 weeks.

[kara]

Course I'm not a doctor, but it does say in the study below that some physicians utilize the multiple dose course...of course, having PE, is an additional compromising factor. Anyway, this is what I found at NIH:

http://consensus.nih.gov/2000/2000Anten ... 12html.htm OR

http://consensus.nih.gov/2000/2000Anten ... 112PDF.pdf if PDF works better for you than html.

"Summary
Data from currently available studies assessing benefits and risks are inadequate to argue for or against the use of repeat or rescue courses of antenatal corticosteroids for fetal maturation."

This particular study is a few years old. And maybe Caryn or someone can pull something more current, but I didn't see anything. Again, I'm not a doc and not sure how it would effect you and your particular case, but it's worth asking your doc or peri for future reference?

[onesock]

Nope, it was Celestone Soluspan for his lung maturity...1 shot and then the other 24 hours later, every week, for a total of 12 weeks...24 shots total.(The normal 2cc dosage) From week 22 until week 34. Now you've got me wondering if that exasperated my issues...and the seconal, the would give me when I went to sleep (I was in the hospital) at 11pm and another dose at 3am (when they woke me up to get my vitals and weight). CRAZY!

[kara]

Wendy, did you have 24 shots in a row? Were they the betamethasone for baby's lungs, or for something else? I'm not sure at what dosage, or how frequently you'd have to have them to cause hbp and fluid retention, but that does seem like a lot...unless they were for something different then lung maturity.

[onesock]

Kara, I wonder if my 24 steroid shots had anything to do with my atrociously high bp's at delivery...besides the fact that they were giving me Seconal at night to sleep, which I understand also causes hbp... HMMM curious.

[kara]

Stacey,

They usually give them between 24-32 weeks (though I'm sure there are cases on either end of that time frame where they've been used). But they usually only give the shots if they think birth is imminent within 24 hours to a week. I've seen most people get betamathasone which is given in 2 doses (preferrably), 24 hours apart. There is a second type of steroid that is given every 12 hours for 4 doses. Both types work the best if you deliver 24 hours or more after you've received the shots. I was induced about 4 hours after I received the last set because they assumed it would take that long to induce me and it was perfect timing.

Lungs don't start to develop until around 24 weeks, so receiving them too much earlier than that is unlikely. And they won't likely give them until they think you are nearing delivery. Multiple rounds of injections are not shown to be better than one round. And ongoing steroid rounds can cause increased blood pressure and fluid retention...neither of which PE moms need :-)...so they are likely to wait until you are nearing delivery.

I think I remember someone getting a round of steroids early on near 24 weeks, because they thought she was going to deliver, but made it much farther and had a second round closer to 32 weeks....

I'm sure different docs do things a little differently...and different situations require different treatment, but that's the general gist.

Email me if you want to chat or vent! :-)

[staceynw]

How many weeks along do you have to be to get the steroid shot?

Have any of you gotten a shot early on "just in case" you had PE again because you were high risk for reccurance?