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Pre-eclampsia and betamethasone 
5th-Jan-2009 10:26 pm [medications, pre-eclampsia, steroid shots]
pregnant belly
Hey all!

A friend of mine, 33 weeks tomorrow, is on bedrest in the hospital, being treated for mild pre-eclampsia and gestational diabetes. She was given betamethasone (dosage finished Saturday), a steroid to mature baby's lungs, and told it masks the pre-e symptoms and freaks her sugars out. The GD is currently being treated with insulin, which is why she remains in hospital, despite awesome BP readings, urine, etc.

Ok, so she was told the betamethasone masks the symptoms of pre-eclampsia, but she is unable to find anything to support this, researching online. Does anyone have any information, links, to support that statement?

Thank you!
Comments 
6th-Jan-2009 04:17 am (UTC)
I don't know anything about the particulars, or how betamethasone interacts with pre-e, but betamethasone is a synthetic glucacorticoid, which means it will do all of the things that glucocorticoids do. Definitely screws with blood sugar levels and ought to increase blood pressure. Also, it will bind to the receptor for a different kind of hormone (mineralocorticoids) which could have an affect on water retention, etc. So I can definitely see how it could mask pre-e symptoms.
6th-Jan-2009 05:38 am (UTC)
Ah, you would THINK it may make pre-e worse... but corticosteroids actually make pre-eclampsia temporarily better. The reason is that they decrease the function of the immune system, and both pre-e and IUGR are partially autoimmune conditions. IT's better documented for HELLP (pre-eclampsia complicated by temporary loss of liver function), but it helps with pre-e as well.

http://www.mayoclinic.com/health/preeclampsia/DS00583/DSECTION=treatments-and-drugs
If you have severe preeclampsia or HELLP syndrome, corticosteroid medications can temporarily improve liver and platelet functioning to help prolong your pregnancy.

http://findarticles.com/p/articles/mi_qa3912/is_199904/ai_n8840751
http://www.highbeam.com/doc/1G1-70975661.html

6th-Jan-2009 05:41 am (UTC)
Best wishes to your friend! I gave you some links down below - corticosteroids help with liver function and platelet count in advanced pre-eclampsia, and while we don't know the exact mechanism in mild pre-e, it seems to be helpful there too. Once your friend is off betamethasone, her pre-e may re-assert itself. The absolute best bet to keep it in check is controlling her sugar religiously, drinking lots of water, eating a high protein diet if her doctor is OK with that, and staying on bedrest (partial bedrest and no stress is usually what it takes).

However, steroids necessitate tighter sugar control, which is why your friend is on insulin right now.

Katya, a doula in NYC


6th-Jan-2009 04:21 pm (UTC)
is this for sarakenobi?
if so, i already emailed her about steroids (short term) and how and why it improves the body systems and the "masking" of pre-e. if not, i'll put it together and post here!
6th-Jan-2009 09:34 pm (UTC)
yeah, it's her :)
6th-Jan-2009 09:35 pm (UTC)
lol - i already had a LONG email conversation with her in that case!
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