Steriod Injections after 37 weeks- advice needed

[mummysweeangel1]

So..story is - i have Gestational Diabetes, on insulin injections, will be 37 weeks on friday, baby being born by ELCS on Thursday next week when i will be a day under 38 weeks.

Baby is above the 95th centile - and my consultant wants me in on saturday to get steriod injections before the ELCS.

Having sat and thought about this- i cant understand why at this stage they would want to give steroid injections if theres been no problem detected with babys lungs, and when i was induced at 38 weeks with my first DS, nobody even mentioned steriod injections and i didnt need tohave them,

Does anyone have any experience of this - are their any midwifes that can offer some advice ? The other thing that concerns me is after they administer the steriod injections, they have advised my blood sugar levels could go really high and that i would then need to stay in hospital on a drip until they do the section on the thursday. I just wonder how effective injections at this late stage would be and now nessecary they are ?

I have not heard of anyone having steroid injections so late in pregnancy.

I had emergency induction with DC1 at 36 +1; a natural labour with DC2 at 37 +3 and a planned induction with DC4 at 37. Steroids were not given, or even discussed.

Can you get an appointment with your consultant so they can explain their reaosns?

That's really odd, did he or she explain the reasoning? Your baby will be full term at 37 weeks. The American professional groups recommend a steroid injection up to 34 weeks, not afterwards. I'd refuse until you get some actual clear explanations of the reasoning behind the procedure, frankly, that sounds really high intervention and I wouldn't want to agree without a lot of talking and research about it.

You're right about the blood sugar; usually if you have GD or diabetes they recommend you up your insulin after the injection. A drip sounds extreme, but I don't know how severe your GD is.

Anyway, sorry, I'm no help, I just wanted to urge you to ask your consultant. You do have the right to resist interventions if you don't feel like you're getting the right explanations.

Thanks so much for the speedy replies - and thats exactly what i feel aswell - that its too late in the day now for these steroids and they havent explained the full reasoning for it - sometimes i just wonder if they just want you in as a "guinea pig" - i feel bad saying that as the staff have been really nice but i do feel i need to know more about this and need to know why they want me to get them so late on.

I will ring the consultant this morning to find out more - have been wakened all night worrying about :(

I suspect it is because GD and high blood sugars can often mean the lungs are slow to mature, also a C-section doesn't give the baby's lungs the extra 'boost' a vaginal birth does.

Recent guidelines from the RCOG regarding antenatal steroids say that steroids should be given to women who are having a planned c section prior to 38+6 weeks gestation and that they do improve outcomes.

Obviously because steroids will make your blood sugars higher and this can then be counterproductive they need to make sure your insulin is kept on track so that the steroids have the desired effect and your blood sugar is kept within target ranges or as near to them as possible.

Due dates aren't an exact science and 37+6 could easily, in reality, actually be 36+5 or less. Plus, there's no evidence to suggest having the steroids is in any way harmful to you or your baby in normal circumstances.

The RCOG guideline is here:

www.rcog.org.uk/files/rcog-corp/GTG%207.pdf

I had steroids on Sunday at 37+1 - I'm having a planned section at 37+6. My previous babies have been born between 36+5 & 38+3 (no steroids) and none had breathing problems BUT an elective section before 39 weeks does carry a higher risk of transient respiratory problems & my consultant was not happy to do a pre-38 week section without them. In my case I was breastfeeding when I conceived and my dates are not certain - it is very easy to be a week out even with a good sized baby.

In my case steroids resulted in a reduction of fetal movements (common apparently) and when I went in for monitoring an unreactive trace which meant I spent all of Monday on the ward. Everything was back to normal after 24 hours but it was scary at the time.

I don't have GD but have had growth issues with thus preggo. I ended up with steroids at 33 weeks which I was surprised about as the growth issues weren't that serious but the consultant who I saw that steroids can often save a bsby's life and as there aren't any side effects to the baby (some for the mummies) they are often given as a preventative measure. But still worth asking more questions about your situation as I had quite a lot of guilt about having them and would have preferred not to......

thanks for all the replies - have to definetly get them - the midwife said its "standard" to give all woman having al ELCS prior to 39 weeks these injections - it is the first i have heard of the "prior to 39 weeks" part though.

So in i go on Monday afternoon noon for them, will more than likely be kept in until babies born after that .