XP: Procardia Past 34 Weeks?

[JCWhitey]

Hello ladies! On Tuesday night I went into labor at 32 weeks, 6 days. It took three rounds of Procardia to slow the contractions down and luckily I only progressed to 2.5-3 cm and my water stayed in tact. They released me yesterday with a week's worth of Procardia to try to keep the contractions at bay. I was told 34 weeks is the latest they will keep me on the meds, but I've been hearing from others that their doctors kept them on it until 36/37 weeks. Obviously I'd prefer to be on it much longer than 34 weeks, 2 days! What reasoning Might the doctor have to cut it off that early?



ETA: This was not my regular doctor. Due to where I live high risk pregnancies get transfered to a larger hospital 2.5 hours away. I met the doctor twice the whole time I was in the hospital and she wasn't really around to answer my questions, it was mostly the nurses. I don't know this doctor, she doesn't know me, so honestly trust isn't 100% there. And sadly my awesome doctor back home isn't able to call a whole lot of shots in this situation.

[ck6113]

I have no experience in your specific situation but I had pPROM at 26w 4d. They stopped labor that day, after many different things, and I was put on hospital bed rest. I was told that if I went into labor again it would not be stopped and if I made it to 34 weeks I would be induced. Luckily we made it to 34 weeks. I know thinking in my specific situation was that DD had better chances on the outside at 34w than on the inside. Is it possible to try and find another high risk Dr? Do you have follow up appoints scheduled with the one that you seen in the hospital? Maybe they can better answer your questions?

[ssm]

I just realized, you are 34.2 today. Any update?

[RedAero]

Hi JCWhitey ! I recognize you from J13 back on the Dump.

I'm an RN working on a high-risk prenatal unit (upstairs from a level III NICU), and to be fair, there are a lot of variations in OB practice. But. I don't think I've personally seen anybody with preterm labor get their procardia stopped at 34 weeks just because they were 34 weeks. That seems a bit silly to me. Most doctors I work with would tend to agree with what you're hearing, that 36 or 37 weeks is when they would stop it.

At 34 weeks I'm guessing you no longer have to be in the high-risk hospital 2.5 hours from your home. Honestly, if it were me, I would transfer care back to your regular doctor and ask him/her to continue your procardia for peace of mind, especially if you start having contractions again. Even if your regular OB doesn't usually manage high-risk patients, writing for 2-3 weeks of procardia should be well within her comfort zone.

In the meantime, if you don't have access to the medication, take it easy. If you start noticing contractions -- even ones that aren't painful -- go pee. Then rest on your left side and drink about 32oz of water. Call the doc or go to L&D if that doesn't chill things out.

Hope all is well!

[JCWhitey]

Thank you everyone for your comments! It's been a rough couple of weeks but I'm still hanging in there and pregnant. I am contracting almost all the time (2-3 an hour consistently since getting released) so I'm getting checked regularly and haven't dilated anymore, but I am now over 60% effaced (I was 20% when released from the hospital). So things are still moving along but at a slower pace.

RedAero Thank you for your reply! My doctor did prescribe me for more last week after I spoke with her about my concerns. The OB in the other hospital just goes under different procedures, I guess. They said at 34 weeks the baby would be "fine", but personally I prefer a no NICU stay over a potential NICU stay situation, so I've been hooked up with more Procardia. My doctor feels like I probably won't make it through this bottle but is willing to let me try.

I am back under my regular doctor's care, but I can't deliver at my local hospital until 36 weeks. There's no NICU or even OR here. Vaginal, med-free, and term only births. My doctor is giving me a 1 week exception since I've had the steroids. If I go into labor anytime before February 18th I have to go back. Blah. I hate that hospital. Mine is just so friendly and nice and everyone knows me. But it's better for the baby if she wants to come early. Btw, congrats on your pregnancy!! Nice to see another J13 momma around!

[coffeeandscrubs]

I took procardia past 34 weeks. Back when I had preterm contractions I researched the drug and didn't find any major adverse effects or contraindications (from what I recall). Weighing the major risk of preterm labor and premature birth and the potential long- term complications against the likely minor risks of procardia the choice was easy, at least for me. I would proceed with the guidance of your Ob but I think many people wouldn't find it necessary to stop at 34. Best of luck and hope this helps!

[JCWhitey]

Quick F/U: Last Tuesday I started having signs of labor again, so back down to the hospital I went. I was 34 weeks, 6 days pregnant and still had three doses of Procardia left (and had just taken one that afternoon). I basically got lectured for taking it longer than 34 weeks. I left out the fact that my doctor at home had no problem with it and they couldn't really tell me WHY they recommend it to 34 weeks only still.

Labor stopped on its own after about 12 hours. I progressed to 4 cm and 75% effaced and have been back home since last Thursday without Procardia because they took what I had left. Still really annoyed by that, but it had pretty much stopped working anyway. Luckily I've had a few calm days so I don't feel I need it anymore as I'm still pregnant and somewhat comfortable almost a week without it. Unless you count nighttime... sleeping has been an issue lately! Luckily I can nap during the day since I'm on modified bed rest now and work won't let me come in more than 3 hours a day anymore.

[RedAero]

Glad to hear you're still trucking along at 36 weeks! That's awesome! Great job, mama.

I would have been pretty peeved about the lecture too, especially when they couldn't give you a rational explanation. You're a nicer gal than I am, letting them take the actual meds from you. I'd have been all, fuck you I paid for these, I'm not giving them to you.

They do tend to lose their efficacy over time, though, so if they weren't really working anyway, NBD I guess. Just happy you're still pregnant and growing that baby! Thanks for the update!