Week 24 - Diabetes and Pregnancy

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Hello. This is Dr. Mauldin. Congratulations! You’re now 24 weeks pregnant!

Almost all pregnant women should be screened for diabetes during pregnancy – most patients are screened between 24 and 28 weeks. Diabetes is a condition that causes high glucose levels in your blood. Glucose is a sugar that is the body’s main source of energy. However, health problems can occur when the glucose levels are too high.

When diabetes is diagnosed during pregnancy, it is called gestational diabetes. Gestational diabetes can occur even if you have no risk factors for diabetes. Although it will usually go away after pregnancy, women who have had gestational diabetes are at a significantly increased risk of developing diabetes later in life.

During pregnancy, any type of diabetes requires specialized prenatal care – because there are certain problems that may occur. Those risks are most increased when your blood sugar levels are high. For example,
1. Diabetic patients are more likely to deliver a baby that is macrosomic – meaning a baby that is very large baby, perhaps one that is more than 9 ½ pounds. If the baby is too large, delivery can be difficult.
2. Preeclampsia is another possible complication. It is a combination of increased blood pressure and increased protein in the urine and is more common among diabetic pregnancies. The condition only resolves when the patient is delivered. So, a preterm delivery is often necessary to protect your health and the health of your baby.
3. Polyhydramnios is seen among some diabetic pregnancies. It is a condition of having too much amniotic fluid around the baby. Although it can cause some discomfort to you, it can also increase the risk of preterm labor and delivery
4. Respiratory Distress of the baby is more frequent among babies of diabetic mothers. With respiratory distress, it is harder for the baby to breathe after it’s born. These babies will have to receive some oxygen to help them breathe – and sometimes that means that the baby will be intubated or have a breathing tube placed.
5. Finally, stillbirth occurs more often in babies of diabetic mothers, particularly when your blood sugars are not well controlled during pregnancy.

Most gestational diabetics are able to control their blood sugars with a combination of diet and exercise. If not, then a pill, called an oral hypoglycemic, or insulin will be necessary. You and your doctor can decide together what method is best for you.

You will need to be monitored closely during your pregnancy and will most likely have a combination of ultrasounds – which will be to evaluate the baby’s growth - non-stress testing – where the baby’s heartbeat is recorded along with any uterine contractions, and daily fetal kick counts.

After birth, most babies do well, but some will need to spend time in the nursery. The nursery staff will be managing any low blood sugars, breathing problems and observing for neonatal jaundice.

Finally, please don’t forget that if you do have gestational diabetes, you are more likely to develop diabetes later in life. This is an important part of your medical history and you should be tested for diabetes from time to time.
Be sure to talk to your doctor about any questions that you have.

I’ll talk to you next week.

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