Betamethasone & PTL

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Hey, everyone, I have a question:

I attended an AWHONN meeting and we were talking about PTL and Betamethasone therapy. The physician that was lecturing was saying that for some strange reason, 12 hours or so after administration of Betamethasone, if you have stopped PTL with tocolytics, the pt will begin to contract again for a brief period of time. Just wondering if you guys had seen this happen. I can't seem to recall in the pt's I've taken care of. Usually I don't have them 12 hours after I've given them the shot.

Thanks!

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Specializes in NICU/Neonatal transport.

Totally anecdotal, but betamethasone always gave me more contractions. They were never able to fully stop my contractions, but betamethasone always made it worse.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Betamethasone has been associated with increased (but temporary) uterine irritibility for years. It's something we watch, but usually these contractions are not the ones that will bring about cervical change. There are things our docs do to offset this or treat it, as needed.

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Specializes in Maternal - Child Health.

I can attest to this as well. I had 2 pregnancies with resistant PTL back in the days when beta-methasone was still given on a weekly basis. Like lil Peanut, my contractions were never completely stopped, but they picked up so much after each beta-methasone injection, that I had to go to L&D to get the shots and be monitored. The OB wouldn't do them in the office any longer.

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Specializes in NICU/Neonatal transport.

Oh yes, my dr. would never give beta outside of the hospital. She figured if you were serious enough to be needing the injections, you should be hospitalized.

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Did you guys notice a time frame for this occurring - hours, days? Any clues as to onset and duration would be great!

Thanks!

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Specializes in Maternal - Child Health.

The contractions would pick up within a few hours, and continue for 12 hours or so. They never resulted in cervical changes, or became uncomfortable. They were mostly a nuisance, but given the difficulty we had keeping my PTL under control, we took them seriously.

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I had betamethasone for both my pregnancies (26 weeker, 29 weeker)...I contracted like crazy within a few hours of each. However, with my first baby...I felt the contractions (ouch)....second baby (3 yrs later) they had to TELL me I was contracting (I had no idea). This was given for preeclampsia, so I had other meds on board as well (mag sulfate).

I also had pitocin with baby #2 so any correlation with the betamethasone in that case quite obviously is masked.

~J

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Years ago we would give betamethasone to our antepartum patients, and 12-18 hrs later they would inevitably start complaining of contractions.

Now if someone gets it they must be continuously monitored. Usually they are receiving Magnesium, so we don't see it like we used to.

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Thanks for your help!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Most of our patients who get Betamethasone are on inpatient status, too. Not all are on Magnesium but most are already getting Terb'd for PTL. If they are stable and cervices unchanging, they may get to go home a short while after the 2nd dose.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

How many of your practioners are using Ffn results to judge whether steriod use is indicated?

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