?? for my sister...

[Holly dolly]

My sister is currently 18 wks with her second child. Her ds was born at 35 weeks (most likely brought on by dehydration---she would only drink Mt Dew...but that's another story for another day). He was small (5lb 13 oz) but otherwise healthy. She had no other signs of preterm labor, BP was always normal, no protein in her urine...etc.

Her midwife wants to do PIO shots starting next week. I'm not terribly familiar with them...and I thought I would ask here what you all thought.

Is this common practice?? Is it something she should ask more questions on?

[swrlgrl105]

When I did PIO shots, it was because I did IVF, and I was always under the impression it was to help your body hold on to the pregnancy, but they usually stop the shots around 12-14 weeks (at least where I go they do). The extra progesterone helps your body before the placenta fully kicks in and takes over, but by 18 weeks, it seems a bit late to start... but Im no expert, just going off of my experiences.

I would definitly ask more questions if I were her. They may want her on extra progesterone since her first was early?

[cristy_1996]

Hmm..are you sure that is what it is called? I had DS1 at 37/6 then DS2 at 35/5. B/C of the shorter gestation the 2nd time the perinatal doctor is suggesting that I do the progesterone shots weekly from 16-20 weeks through 36 weeks.

Her baby was NOT small for that gestation..probably about right..mine was 5lbs 11 ozs and perfectly healthy. And sometimes there is no reason for preterm labor. I had none and took great care of myself.

I am choosing to get the shots but they are called 17-OHP I think. It is an oil based shot weekly into your hip. I've heard they suck but will find out myself next week. I am starting them Thursday. :-/

The way my doctor put it, it is the only intervention they have for preterm labor. It is still no guarantee but statistics show a good chance of baby staying in longer. If I go 2 weeks earlier than DS2, baby will for sure be in the NICU so I am doing all I can to keep that from happening.

[Holly dolly]

I asked her again and she said it is the shot in the hip. Guess I need to ask HER more questions.

I know her ds wasn't small for his gestation...but her mw questioned her dates at that point.

[Bella Catalina]

Yeah, 17-OHP is what I'm thinking the OP is referring to, and higher progesterone levels help. I've also heard a friend call it P-17.

That size is pretty good for 35 weeks, but obviously the brain growth and development in the last month is phenomenal, as well as lung development, and if she has another 35weeker, there's no guarantee this baby will do as well. I had my first at 36w and he was "fine" as in no NICU time (though I know plenty of 36weekers who have needed it), but still had temperature issues, major sleepiness, nursing issues, and severe jaundice. I carried my 2nd until 38w, though, and there was a world of difference. So while there's no guarantee (and who knows, she could carry this one to term regardless), I think it's worth it. Oh, and a heating pad on the area before and after the shot helps a lot

[songbird516]

http://academicobgyn.com/2011/03/17/boycott-makena/

Here is an article that talks about the push to prescribe this drug to any women who might remotely benefit. It seems like since it's been patented there are a lot more women getting it, try to guess why.

35.5 weeks seems like pretty close to the cut-off. Personally I wouldn't take it with that history, as the benefits probably do not outweigh the risks. There is some chance that it might help women who have a history of preterm birth, but imo it's more likely to help women who have preterm labor starting much earlier. It seems like statistically there is a small chance of improved outcome with the injections, but risks always need to be weighed in light with benefits. Some women say the shots made them feel really crappy. I would for sure find out more details and get a list of what is in the injections. (other than the progesterone).