Meds to stop contractions

Can anyone educate me on the various meds used to stop contractions? I'm currently on 50 mgs of Indomethacin which the hospital told me was like Motrin (ibuprofen). The other one they gave me in the hospital was Nifedipine (10 mgs). When I asked why I wasn't continuing both after they sent me home, I was told that Nifedipine is not typically given to people at 19 weeks. Neither of these are drugs I've heard of before. I've heard others talking about Terb-something and mag sulfate. When I asked about those meds, I was told they aren't used any more. Well, obviously they are because I keep hearing about people using them. I'm concerned because I'm still feeling a lot of contractions. I keep wondering if there is some other drug I could try that might work better. I want to do anything I can to keep these babies inside. We have a long ways to go before they are viable and my cervix is funneled to 1 cm. I'm so worried. Thanks for any advice!

 

When I started having contractions around 23 weeks, they started me on Nifedipine (also called Procardia). But it lowers your blood pressure so if you are having BP issues, they may not prescribe it. Then I moved onto Terbutaline when the Nifed wasn't working anymore (around 29 weeks). But if you have blood sugar issues they won't prescribe it because it can exacerbate gestitational diabetes. Then at 30 weeks I was hospitalized with pre-term labor (from 24-30 weeks I was just having pre-term contractions, but my cervix wasn't changing) and they put me on magnesium sulfate to stop it. Thankfully after a day on it (its an IV), they were able to stop the labor and I think I went back on terbutaline. Since I started having contractions further along in my pg than you are experiencing now I can't give you any advice other than talk to your doctor.. and if you aren't seeing a maternal/fetal (or perinatologist), get one! My peri was fantastic and we held on until 34 weeks. Good luck and drink lots of water and stay off your feet!! -Leighann

 

QUOTE(Leighann @ Oct 6 2007, 08:16 PM) [snapback]438754[/snapback]
When I started having contractions around 23 weeks, they started me on Nifedipine (also called Procardia). But it lowers your blood pressure so if you are having BP issues, they may not prescribe it. Then I moved onto Terbutaline when the Nifed wasn't working anymore (around 29 weeks). But if you have blood sugar issues they won't prescribe it because it can exacerbate gestitational diabetes. Then at 30 weeks I was hospitalized with pre-term labor (from 24-30 weeks I was just having pre-term contractions, but my cervix wasn't changing) and they put me on magnesium sulfate to stop it. Thankfully after a day on it (its an IV), they were able to stop the labor and I think I went back on terbutaline. Since I started having contractions further along in my pg than you are experiencing now I can't give you any advice other than talk to your doctor.. and if you aren't seeing a maternal/fetal (or perinatologist), get one! My peri was fantastic and we held on until 34 weeks. Good luck and drink lots of water and stay off your feet!! -Leighann


I agree! hydrate, hydrate, hydrate.....dehydration is one common cause of PTL. lay down too.....I started contractions at 20 weeks. I was prescribed Terbutaline, this was just last week! I am in Florida.....and most importantly see a Perinatologist!!

Let us know how you are doing,


Missy

 

I am drinking so much water that my pee is completely clear. I've never had that in my life. I also have to pee every 20 min. It was a peri that told me there was nothing more they could do at this point in my pregnancy. I am on bed rest and only getting up to go to the bathroom. I'm starting to think I need a second opinion from a different peri.

 

QUOTE(Beth*J @ Oct 6 2007, 09:43 PM) [snapback]438859[/snapback]
I am drinking so much water that my pee is completely clear. I've never had that in my life. I also have to pee every 20 min. It was a peri that told me there was nothing more they could do at this point in my pregnancy. I am on bed rest and only getting up to go to the bathroom. I'm starting to think I need a second opinion from a different peri.


Beth, that couldn't hurt either. If you don't feel like you are getting complete and competent information/health care....get a second opinion...and do it soon!....I know how scary all of this is. I have been on bed rest for 17 WEEKS!! Since week 5 of my pregnancy. You take care of yourself....and these babies...keep up the good work!


Missy

 

I was on terbutaline (pill not the pump) after my cerclage and they said it stopped my contractions, but I wonder since Emilie was born 10 days later.

Beth, have you gotten the steroid shots? Has your OB even mentioned them to you? I think you should ask for them if they have not been mentioned.

 

I was on Terbutaline during my pregnancy but my body kept getting used to it so I was still having contractions. I was in and out the hospital for pre-term labor and contrax. like my whole pregnancy to be put on Mag. :bad: They do still use these drugs, I don't know why they told you they don't.

 

You are all so helpful. Please keep the posts coming. I was told it is too early for steriod shots. You can bet I will be demanding them when we get to 24 weeks. If we get them at that point, how long do they last, will we have to get them again later in the pregnancy? The hospital indicated they didn't know how long they were effective.

I'm calling my regular OB tomorrow to ask about terb and how to get a second opinion from another peri.

 

Have they mentioned anything about getting a cerclage? I don't know if that is something you would be a good candidate for, since I don't know how you cervix is measuring, other than it is funneling.

When I was put on bedrest at 24 weeks, I started on 10mg of Nefedipine (Procardia). By the end of my pregnancy, I was on 30mg, which I was told was the highest dosage. I started oral terbutaline (pill form) at home when I was discharged. That didn't work too well and I was rehospitalized. While there, I was able to get the shots which were more effective. My doctor was concerned about how much I was taking, and introduced Percocet to my med list. Although this is a narcotic, it is also a muscle relaxer, and he uses this med to calm down an irritable uterus. It worked wonderfully and for the most part, we were able to manage my contractions by 1) staying well hydrated, 2) taking nefedipine, and 3) taking percocet.

I was also on antibiotics a couple of times for possible infections (which can cause contractions) which were found in routine blood or urine tests (high white blood cell counts). I also took stool softeners and charcoal tablets to keep things moving so that I would not have to bear down at all for a bowel movement. Lovely, eh?

I wish you the best of luck. It must be scary. If you feel like you are not getting the best care, seek a second opinion. My OB felt that she was not qualified to deal with my issues, and encouraged me to hand over 100% of my care to my peri. I am glad she did; he was more than qualified to care for me. And although the nurses felt his "Med Cocktail" was a bit excessive at the inclusion of narcotics, I really believe that it helped me to deliver two healthy babies.

 

My cervix is only 1 cm. I want a cerclage, but the peri said I wasn't a candidate because I was having contractions. That didn't make sense to me.

 

I'm hearing you! I was in L&D last night contracting. Thankfully, a shot of Brethine (Terbutaline) did the job in stopping them. (Terb and Mag are definitely still in use, I see people on them all the time) I'm going to call the Dr tomorrow and see where we go from here. They didnt want to check me last night in fear of starting the contrax back up, but I really want to know if my cervix has changed any and get a handle on if I am going to be on permanent bedrest or if I need to stop working now and all of that stuff.

With my first pg, I was on a terbutaline pump at home, I don't think too many Drs use the pumps anymore, but it worked for me. Occasionally I had to go in the hospital and do a Mag wash - I think it was called - it kind of cleaned all of my cell receptors out or something giving a fresh slate for the terb to keep working. The Mag sure did make me feel bad, but it did the job.

I hope you get some answers from your Dr soon. I'm sure if you are anything like me right now, you are just wanting to fast forward through the rest of this trimester and make it all go by fast! Take care.

 

QUOTE(Beth*J @ Oct 7 2007, 08:17 AM) [snapback]439287[/snapback]
My cervix is only 1 cm. I want a cerclage, but the peri said I wasn't a candidate because I was having contractions. That didn't make sense to me.


Can anyone out there weigh in on this...I have never heard that as a reason and am curious what others have experienced????

ETA: Found this quote from WebMD: "[A cerclage] is not used when a pregnant woman has vaginal bleeding or uterine contractions or if her membranes have ruptured early."

 

QUOTE(Beth*J @ Oct 7 2007, 11:17 AM) [snapback]439287[/snapback]
My cervix is only 1 cm. I want a cerclage, but the peri said I wasn't a candidate because I was having contractions. That didn't make sense to me.



Beth, I am pretty sure I was having contractions when I had my cerclage because that was the day after that they sent me and when I got there and they hooked me up to the monitors I was having contractions, even though I couldn't feel them. So I don't know what to tell you because I am pretty sure I was having them when I had mine done. Maybe it depends on how often and the severity of them, I don't know.

Kate-that is interesting info. from Web MD.

 

Hi Beth,

First off, I agree that maybe you get a second opinion. I had an emergency cerclage done at 16w5d, I was contracting and I had 0.2cm (that's 2mm) of cervix left. They put me in the trendelenberg position overnight, hydrated me with IV fluid, started Indocin (Indomethacin), and started antibiotics. The cerclage worked and got my cervix length back to 3.5cm. I did contract for about 3 hours post-cerclage, they double dosed my Indocin and got the contractions to go away.

I was kept on the Indocin and home bedrest because it was so short so early. They took me off Indocin at around 20 weeks because it cause baby A's fluid to get low. Two weeks later, my cervix length had shrunk down to 1.2cm, the admitted me overnight and started me back on Indocin. A week later (at almost 24 weeks) my cervix was still short and they admitted me to hospital bedrest (23w5d). I was admitted on a Friday, and on Sunday at 12:00am, the very minute I turned to 24 weeks, they gave me my first steroid dose and I got another one 24 hours later. They normally won't administer the steroids until 24 weeks because they really aren't effective before that. Oh, and upon being admitted to hospital bedrest they put me on Nifedepine as well.

I was never on terb or mag, my peris felt Indocin and Nifedepine were effective (and they were in my case). I saw the peri group out of a very large, well know university hospital. They said Indocin worked best prior to 24 weeks, then both of them worked for me in the second trimester, and once I hit 26 weeks they took me off the Indocin because it could cause the ductus arteriosis to close prematurely in the womb.

I did deliver early, but not because my cerclage gave out. Baby A PROM'd at 30w5d, they gave me a rescue dose of steroids and I delivered 48 hours later because she was attempting to push her cord out with her foot. My girls are doing very well.

 

Thank you for all your posts. I appreciate it.

I am back home from the hospital now. I didn't post earlier because I didn't have much to tell you. I've been kind of a basketcase because I am still having contractions and I didn't know how they were affecting my cervix. My regular doctor saw me briefly today even though I have a regular appointment on Thurs. The good news is that my cervix seems to have improved some with the bed rest. I'm still only on the Indomethacin, but since things are improving, I don't feel as desperate to be on additional meds. Also, my doctor took the time to answer all my questions, which really helped me emotionally. I couldn't get anyone to answer questions for me at the hospital and that made me about crazy. So, for the time being I'm still on bed rest, but I'm not freaking out every time I feel a contraction. I'm allowed to get up to use the bathroom and do short activities like make a sandwich or let the dogs out. It's kind of scary not to be able to work or do anything, but we'll do everything we can to keep these babies happy and healthy.

 

Beth, thanks for the update. Glad the bedrest helped your cervix a bit, that is good! Thinking of you and the babies. :hug99: Keep us posted!