Steroids – any thoughts?

Just a quick post based on today’s doctor’s visit.

I had my first non-stress test done today…all was well.   So, that’s good, but…

The doctor is recommending steroid shots (2 shots 24 hrs apart) to help with organ development in the event of a preterm birth.  She is basing it on my cervix going from 2.2cm to 1.6 cm in 2 weeks.  I told her that the 2.2 may have been a fluke because it has always been at 1.6 since the cerclage was placed, but she reiterated that she recommends I get the shot.  She said they need to be done soon to be effective.  She said they can’t harm the baby, but the negative is that they can mess up my blood sugar control.  This is an issue for me because I have GD.  I’ve been doing very well with my daytime blood sugar numbers, but my fasting morning numbers have been below the limit only 50% of the time.  Considering the fasting number issue and the fact that she wants to have me take the steroids, my OB recommended that I start a little insulin at night.  She is referring me to the MFM (high risk) group for them to make the ultimate decision.   They should be contacting me soon (hopefully by tomorrow) for an appt.

Has anyone taken the steroid shots?  Any concerns over short or long-term impact to the baby?  Also, has anyone had to take insulin for GD? 

I really wonder if my OB is recommending the shot because there is documentation that shows my length drop from 2.something to 1.6 cervical length, even if that didn’t really happen.  Sometimes it’s so hard to just trust a doctor, but in the end, that is all we can really go by.  I am not feeling good about taking all these things.  I still don’t feel comfortable with the progesterone shot to help prevent preterm labor.  Now this!  Ugghhh….more decisions/discomfort.


8 Comments (+add yours?)

  1. R
    May 17, 2012 @ 19:48:45

    Hey, I dont know about the steroid shot but I did take insulin for my GD. The needle is waaaay smaller than all IF drugs and it wasnt a big deal. I took the insulin 15min before every meal and before bed. If you have any specific questions Im happy to answer.


  2. soulshine
    May 18, 2012 @ 13:37:54

    well, i got the steroid shots shortly after they admitted me to the long-term stay area of the hospital. i think it was somewhere between 31-32 weeks? my attitude about it was ‘anything you say to do, i’ll do it’, so i had no hesitation about having them. the fact was, i could have gone into labor at any point, and if that happened before the scheduled c-section, i wanted the benefit of the steroid shots for his lungs. i had no side effects (don’t know if there are any to have?). the shot was no big deal in the big picture of the pile of needles i’d already seen.

    he ended up staying in until 36wks. he stayed in the nicu for only 1 day- really less than a day, just needed a little watching. his lungs were fine, and i don’t know if it was because that was just that way, or if the steroid shots had something to do with it- i never thought to ask after the fact. i did, however, get asked a lot by everyone if we had already had the steroid shots- they make a big difference in early babies, so, there is a definite benefit from having them.

    i would absolutely ask about the risks of getting the shots in the case of not needing them in the end.

    and, you know we also took 17p shots up until the end. thus far, and from the get-go, we had zero issues with anything. he’s a little delayed in general, but only by a few weeks and they said to expect a little delay because he came out a tiny bit early. all babies born early in the state i live in get follow-up home nurse care to make sure they are thriving in the home environment. i wonder if your state has the same thing? it may be worth asking about just to know, it could give you a little more reassurance if your sweet baby does end up coming a little early.

    i have NO idea about the GD, and how it relates to the steroid shots- i would get as much info as you can before you make the final decision. your cervix is holding up so well, and hopefully the decrease (& increase) was just a fluke in numbers overall. but if your babe did happen to come sooner than later, those shots will help with their lungs, no question. find out about the risks, and i know you will make a good decision about it.

    how often do you get measured for cervical length? will they keep a closer eye now that they have seen that decrease? also, it is nearing the time that you could possibly take a NICU tour, a l&d tour, etc. have you thought about doing that? sorry if that is too intrusive? i took a tour of the NICU and i left there feeling very hopeful that if i did have an eary baby or if he had issues, he would be under excellent care and it took a layer of fear of the unknown away.

    thinking of you every day! kisses for daisy-dog!


  3. Anonymous
    May 18, 2012 @ 16:39:42

    Hang in there – you’ve come so far! You are doing a lot better than I did… I hope you are celebrating getting to significant milestones (28 weeks!). I did get steroids with my first… actually at the time, I think they were okay with two rounds – so one when I was 24 weeks and had just got to the hospital.. and then when I start leaking amnio fluid – 2 days or so before I went into labor (31 weeks). But since then I think they limit to just one round. My second did not require steroid shots… but I would have received them if there was warning of prematurity. I remember them also reassuring me that there were no ill effect on the baby, only that it will help them produce surfactant (?I think…) and help with lung development – so I was all for it and was just worried that they wouldn’t be able to get them in me in time. My MFM really believed the steroids made the difference in the health of my son… he was in the NICU for 5.5 weeks – but basically no major health issues – just to grow (they always say the NICU is a roller coaster – but we lucked out and did not have any real setbacks). So the two things I would focus on for you – is the timing of the steroids – I think it does sound a little early considering that you still have cervical length (I think I was down to under 1 by 23-24 weeks) and a cerclage… and I can’t remember what gestational week they stop giving steroids (34 weeks?). And the second thing is your health if the steroids can cause issues with the GD… so better understanding those risks sounds key (do they think the GD is what is going to cause you to go earlier over the UU?). But bottom line – I would trust your MFM’s advice… if they think this is the time for steroids and that how it interacts with GD is a risk factor that they have considered…

    Ultimately though – your baby is going to be in good shape… probably already 3.5 lbs, major organs formed, just wants some more incubator time!!! Great Job Dianne!



  4. Anonymous
    May 18, 2012 @ 18:13:33

    Wish I could offer some insight, but I’m clueless. Just wanted to drop in to tell you that I’m thinking of you. Have a great weekend!


  5. MyTwoLines
    May 18, 2012 @ 20:31:20

    My recommendation is to do the shot but get the glucoses managed by an endo not just your ob. We see lots of gestationals at our office and they email their glucoses in and we adjust insulin to keep things super tight!


  6. Cassie
    May 19, 2012 @ 10:37:48

    I have no experience with this stuff, so no advice to give, but it sure sounds to me like the shots would be for the best. I know it can be hard to trust everything the doctors say, but they have gotten you this far and it is looking good. I’m so happy that you have made it to this point and am so excited for you!


  7. soulshine
    May 26, 2012 @ 13:06:26

    hey! how are you doing this week?!
    thinking of you 🙂


  8. Pearl
    May 27, 2012 @ 16:14:56

    The shot can make a huge difference for a premature baby… I hope that whatever you decided, your GD is still under control.


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