Injections to mature baby's lungs

[CoteDAzur]

I'm in hospital since Friday for high uric acid levels in blood (470, way above 350 upper limit of normal range. They want to start me on cortisone (?) injections for 48 hours and have baby out straight afterwards, a day before my 48 weeks.

Just how risky is this lung maturing process? Once we start the injections, does baby have to come out in 48 hours or can we delay birth if my uric acid levels miraculously come down?

how pg are you?

I assume you mean the steroid injections? I had them at 32 weeks. My ds was born at 37 weeks naturally. I don't think there's any need for the baby to be born just because of the injections but your doctors are the ones to ask.

HTH

my situation was exactly the same as eeek - I had them at 31/32 weeks and ds2 was born at exactly 37 weeks.
but I had them because of contractions and the concern of an early labour - not because of worries about the health of the baby in uterus.

There is no need for the baby to bee born after steroid injections have been given, however in the UK the wouldn't be given routinely at your getstation (IIRC you are post 37 weeks)as the lungs are fully matured by that point.

I had the steroid injections last wknd at 31weeks pg. I wonder is it the norm to go early after you've been given these injections? Does anyone know? My case was also due to mild contractions but am feeling fine now thank god!!

no idea - my ds1 was also exactly 37 weeks, so it didn't seem early to me.

I'm 37.5 weeks.

Baby is fine. My blood pressure is fine and I have no contractions. Baby is not engaged and cervix looks nowhere near labour. Problem is uric acid level in my blood is way above normal.

Ok if there is no need to birth baby soon after injections, I don't mind having them.

LeninGrad - I'm accessing Internet on phone, so finding it hard to research online. Could you explain a bit about links to CP?

why do you need the injections at 37.5 wks? lungs should already e mature?

No idea. I haven't seem my doctor since. I was hospitalized Friday evening. And havent beem able to finf advice online until i found a corner of room that gets some wi-fi.

A nurse showed up by my bed with a needle Saturday morning (yesterday). I refused it, because I hadn't discussed it with my doctor, and he wasn't aware of blood result of 1am that showed lower (but still very high) levels.

I was hoping it would continue to go down and I would be anti hold on at least to 38 weeks, bug that doesn't look likely now.

Think Cote is having a c-section and there are increased risks of breathing difficulties with c-section deliveries before 39 weeks.

Good luck cote.

My sister also had the injections at 32 weeks but didn't go on to actually have the baby until 42 weeks.

I just googled the CP stuff and only found this:

"In our study, the babies with the highest number of repeated steroid injections five or more we found a non-significant but an increased risk of possible cerebral palsy," said Dr. Ronald Wapner, director of maternal-fetal medicine at Columbia University in New York City.

Am interested in this though so will do more digging as i've had a baby at 37 weeks by c-section who did have breathing problems and am keen to minimise the risk of this happening again in this pregnancy.

Argh. Stupid auto-correct on phone

able to hold on to 38 weeks
but that doesn't look likely now

Cote I think the risks were when multiple steroid injections were used in the past. The benefits for lung maturity are thought to outweigh any disadvantages of 1/2 steroid injections in the UK. Mind you I thought they were ineffective after 35 weeks

Afaik I'm still having a CS. A MW did a strep b test yesterday, though, saying might have a VB

Mspotatochip - I don't mind ineffective. Is there a downside to having 1-2 injections?

Normally steroid injections are given where preterm birth is expected before 35 weeks, but I have seen steroid injections given when it is known the baby is going to be delivered by caesrean section before or around the 37 weeks mark. It is done in an attempt to get the baby to produce more natural surfactant which helps the lungs at delivery. Babies born by elective caesarean are more likely to have breathing problems when born before 39 weeks as they have not been stimulated by labour which in turn stresses the baby and produces more natural surfactant.

Do you have raised blood pressure as well as high uric acid levels?

I had a two rounds of this injection each time when I was 32 weeks with dd1 and 35 weeks with dd2 (I had placenta praevia twice so this was just in case I ruptured and had to have them before 36 weeks). No problems at all - except the injections bloody hurt! But it was over very quickly.

good luck.

Thank you for that, tracey.

Realised I nwever answered the question - no baby does not need to come out straight after injections but it sounds as though it may need to if blood pressure is up.

Is the high uric acid due to obstetric cholestasis?

I had OC with both my DCs. I was induced at 37+0 weeks with both. Neither had steriod injections - DS (DC1) had a little tiny bit of breathing difficulty, nothing that required any help and it cleared quickly and DD (DC2) had no difficulty whatsoever. I would have been induced sooner with DS - doctor wanted to but hospital didn't have enough beds.

My cervix was unfavourable and I had a low bishops score, but the inductions worked quickly both times.

cote I have no proper information only what was discussed with thelady in the bed beside me at day assessment unit last week! The doc here in uk said they only generally do one now as it seems to do the job but they try to time it right for maximum effect (she was looking at prem labour of twins). I follow a Us forum on pre eclampsia and they seem to favour 2 injections 12 hours apart. There are a lot of links on there www.preeclampsia.org/forum/default.asp.

Basically Mears know whats shes talking about and I've just remembered stuff I've heard!

Do they think you have pre eclampsia? I know from previous threads that you are in French / Monaco system and patients seem to be the last people consulted!

Good luck getting some answers and I hope its all a fuss over nothing! Oh and I hope yo

Hi Cote, Sorry to hear you're in hospital. The current evidence would indicate that only two shots of steroids are needed to help mature the lungs, but as other posters have pointed out, they are normally only given to preterm babies. So why they're giving them at 37+5 is a bit beyond me. A quick scoot 'round the tinterweb came up with this on steroids in pregnancy it seems pretty comprehensive. http://www.indianpediatrics.net/april2002/april-347-361.htm
Hope you get some answers from your doctor soon.

get your c section as planned!