Gestational diabetes
Diabetes is a condition characterized by a high level of sugar or glucose in the blood. Diabetes that occurs only in pregnancy is known as gestational diabetes. During pregnancy, hormones cause the woman's insulin to be less effective at metabolizing glucose. The resulting high blood sugar can lead to complications in both the woman and baby. The condition disappears after pregnancy for the vast majority of women, although a third of afflicted women become gestational diabetics with subsequent pregnancies. In later life, they are also more likely to develop non-insulin-dependent diabetes. Most women who are well controlled during pregnancy have good pregnancies and healthy babies.
The risk factors for developing gestational diabetes are family history, previous large babies or previous gestational diabetes. The condition is more common in women who are obese or over the age of 25. Most practices screen all women at 28 weeks for the condition with the glucose tolerance test. Once a positive diagnosis is confirmed, the pregnant woman is placed on a diabetic diet. Home monitoring of blood sugar is performed several times a day. If diet alone does not control the blood sugar, insulin may have to be given.
The babies of untreated diabetic women may be very large, making delivery more difficult. Other complications include respiratory difficulties, jaundice, a low level of calcium in the blood and stillbirth. If the diabetes is not controlled, hypoglycemia (low blood sugar) may occur after birth. While in uterus, a baby produces high levels of insulin to absorb the woman's high blood sugar. At birth, the woman's supply of sugar drops and the baby's high level of insulin may cause his own blood sugar level to drop very low. Nursing soon after birth helps to prevent hypoglycemia.
Women who have diabetes are more likely to develop pregnancy-induced hypertension. To prevent stillbirths, their doctors may induce labour before or on the due date. If the induction is not successful, a cesarean section is performed. Infection and postpartum haemorrhage are also more common in diabetic women.
|