When are steroids necessary?

[schmella]

Because I'm a worrier. I've mentioned to every doctor we've seen that I have a corticosteroid sensitivity- I've been advised never to take/use them unless its a life or death situation.  So far, I've experienced muscle atrophy after 3 days on oral steroids for an allergic reaction and central serous retinopathy which has resulted in a small blind spot in my left eye from Flonase use.  I'm trying to find a specialist to really define what my risks are with a steroid injection, but to be clear- I'm not talking about refusing steroids unless it actually puts my life in danger.  I can deal with muscle weakness and temporary/permanent blind spots, but I don't want a doctor being overzealous and giving them to me at 30 weeks as standard practice, you know?    None of my doctors has mentioned the possibility of steroids in the case of premature delivery (but I know it will come up), and I feel like this board will probably have the most experience with this.  If I make it to 35 weeks, would steroids be necessary? 32 weeks? Basically, what is the cut off, and could we wait to do this until there is a sign of trouble, or would that be too late? 

[carrotcake]

Generally, steroids are not given after 34w. Ideally, it's 2 shots given 24 hours apart and no more than a week before delivery. They are not given in the general course of a typical twin pregnancy.

I was dx w mild pre-e at 32w and was given two steroid shots, 24hrs apart. I was told that that would be sufficient until I either delivered or hit 34w, whichever came first (coincidentally, I delivered right at 34w). I was given the option to decline the shots as well.

I forget most of the readi go did at the time, but it is believed the shots help w Lung development and a couple other things. My boys didn't need any breathing support and had a short, uneventful NICU stay, but I can't say whether the shots played a role in that or not.

[beachy]

No they aren't part of standard care, even in twins. They would only give them to you if they thought birth was imminent before 34 weeks I believe, and it's to help the lungs develop more and give the babies a better chance.. Like PP said its only good for a week though. So basically you're only going to be given them if its absolutely necessary.

[anotherdreamer]

They would only be given if they feel pre-term delivery is imminent and it was the best course of action. I had a scare at 28w (stomach bug, dehydrated, contractions 2-3min apart but not dilated at all thankfully) and they did not mention steroid shots, they gave me meds to calm my uterus and fluids plus anti-nausea meds. The meds did their thing and I went home. It really just depends on your situation.

[babyksmommy]

There aren't standard practice, they are only if they fear delivery is imminent. I was admitted at 31+3 for PPROM. Because they weren't for sure what was going to happen they gave them to me immediately and then again 24 hrs later. They wanted to potentially keep the babies in until 35 wks but we didn't know what was going to happen .They were born at 32wks exactly and I strongly believe because of the steroid shots they had no problem breathing on room air from the beginning.

My sister also had twins at 32 wks, she was not as lucky and didn't get to have there steroid shots. Her twins were on CPAP from the beginning. Her twins are 9 months and there are no lasting effects, it just means they had more intervention at the start of their life.