Steroid injections are administered during pregnancy only under specific medical circumstances. This treatment is not a routine part of prenatal care and is instead carefully considered by healthcare providers. The decision to use steroid injections involves a thorough evaluation of the potential benefits versus any associated risks for both the pregnant individual and the developing fetus.
Medical Reasons for Steroid Injections During Pregnancy
Corticosteroid injections are commonly used during pregnancy to accelerate fetal lung maturation when there is a risk of preterm birth. This intervention helps to reduce the incidence and severity of respiratory distress syndrome in newborns. The benefit is typically seen when these injections are given between 24 and 34 weeks of gestation, though some guidelines extend this to 36 weeks and 6 days in specific situations.
Steroid injections may also be considered for pregnant individuals with certain maternal autoimmune conditions. Diseases such as systemic lupus erythematosus or rheumatoid arthritis can flare during pregnancy, requiring management to protect the mother’s health and prevent complications. Corticosteroids can help suppress the immune system and reduce inflammation in these cases. The dosage and type of steroid are carefully selected to balance maternal disease control with fetal well-being.
In rare but serious scenarios, corticosteroids might be administered for other acute conditions affecting the pregnant individual. This could include severe allergic reactions, such as anaphylaxis, where rapid anti-inflammatory action is required. Certain neurological conditions, like acute exacerbations of multiple sclerosis, might also warrant steroid treatment during pregnancy. The decision always rests on the medical necessity and a thorough risk-benefit assessment by the healthcare team.
Types and Administration of Steroid Injections in Pregnancy
Two corticosteroids, betamethasone and dexamethasone, are commonly used during pregnancy to promote fetal lung development. These steroids effectively cross the placenta to reach the fetus. Once in the fetal circulation, they stimulate surfactant production, which helps the tiny air sacs in the lungs expand and prevents them from collapsing. This action significantly improves the baby’s ability to breathe independently after an early birth.
For fetal lung maturation, a course involves two doses of betamethasone given intramuscularly 24 hours apart. Alternatively, four doses of dexamethasone may be administered intramuscularly every 12 hours. This dosing regimen optimizes the benefit for fetal lung development while minimizing potential adverse effects. The timing of administration, between 24 and 34 weeks of gestation, is crucial for maximum effectiveness.
Systemic steroid injections for medical purposes during pregnancy differ from localized steroid injections. Localized injections, often given for pain management in joints or for cosmetic procedures, are avoided during pregnancy due to limited data on their systemic absorption and potential effects on the fetus.
Potential Side Effects and Monitoring During Pregnancy
Administering steroid injections during pregnancy can lead to temporary side effects for the expectant mother. Common effects include a temporary elevation in blood sugar levels, so blood glucose monitoring may be recommended. Other potential maternal effects include fluid retention, temporary mood changes, and a slightly increased risk of infection due to the medication’s immune-suppressing properties. These effects are mild and resolve shortly after the course of injections is completed.
For the baby, temporary changes may be observed after the mother receives steroid injections. These can include a temporary decrease in fetal movement or altered fetal breathing patterns, which are monitored through non-stress tests or biophysical profiles. Current research indicates no significant long-term adverse effects on neurodevelopment in children exposed to a single course of antenatal corticosteroids. The medical consensus is that the benefits of preventing respiratory distress syndrome in preterm infants outweigh these potential, temporary effects.
Steroid injections are only given under strict medical supervision and after a careful, individualized risk-benefit analysis by healthcare professionals. Following the administration of these injections, the pregnant individual may undergo specific monitoring. This monitoring can include regular blood sugar checks to manage any temporary elevations and ongoing fetal monitoring to assess the baby’s well-being. Pregnant individuals should openly discuss all concerns and their complete medical history with their doctor to ensure the safest and most appropriate care plan.