Gestational diabetes insipidus occurs during pregnancy. This is a type of diabetes and about 2-10 percent of expectant mothers develop this condition. When pregnant, hormonal changes make your cells less responsive to insulin. But during pregnancy, the pancreas cannot keep up with the increased insulin demand, and hence blood glucose levels rise resulting in gestational diabetes.
Significantly, most women with gestational diabetes do not remain diabetic after the baby is born. Once you've had gestational diabetes, though, you are at higher risk during a future pregnancy and for developing diabetes later in life.
Symptoms of gestational diabetes
There are no symptoms and that is perhaps why all pregnant women have to undergo a glucose screening test between 24 and 28 weeks. If you are at a high risk for diabetes and are showing signs of it, then the doctor would recommend this screening test at the first prenatal visit and then repeat at 24 weeks, the initial test being negative. Follow up tests are done to find out if the result on glucose screening is positive.
High risk factors for gestational diabetes
The American Diabetes Association prescribes the following condition for early screening, in case of high risk namely:
Obesity and BMI over 30
If you have had gestational diabetes in previous pregnancy
If the urine has sugar and
If you have a strong family history of diabetes.
Other risk factors
If earlier delivery was a big baby
If you have had a stillbirth
If you have high blood pressure and
If you are over 35.
An association between excessive weight gain during pregnancy, particularly in the first trimester and risk of gestational diabetes has been established.
Gestational diabetes: Pregnancy and baby
Poorly controlled diabetes may have short and long term consequences for you and your baby. If blood sugar levels are too high, the baby's blood may have too much glucose. The excess blood sugar and insulin can cause the baby to put on extra weight particularly in the upper body. This can lead to a condition called macrosomia. This baby may be too large to enter the birth canal or the baby's head may enter but shoulder may get stuck. This is a tricky condition called dystocia and the doctor has to use special procedures to deliver the baby.
Sometimes delivery of such babies may result in fractured bone or nerve damage which could become permanent in 99% of babies. It is better that babies of mothers with gestational diabetes, check their blood sugar regularly and breast feed the baby immediately after birth to prevent or correct hypoglycemia.
Such babies with hypoglycemia at birth are given IV glucose solution. Testing the baby's sugar and providing an IV if necessary can prevent serious problems such as coma, brain damage and seizures. The baby also exhibits high risk for breathing problems and newborn jaundice. In addition, the baby is also at risk for polycythemia or increase in the number of red cells in the blood and hypocalcaemia or low calcium in the blood. Women with gestational diabetes are at an increased risk of developing Preeclampsia, particularly those who are obese before pregnancy and blood sugar levels are uncontrolled.
Macrosomia is a condition in which a baby is unusually large before birth. The baby's weight could be more than 8-9 pounds. Babies born with macrosomia might suffer from jaundice, low blood sugar, respiratory distress, etc. Pregnant women who gain weight rapidly and have a heavy stomach might be at risk for macrosomia. Women with large fundal height, the distance from top of the uterus to the pubic bone might indicate Macrosomia.
Gestational diabetes or diabetes mellitus is usually the main cause for macromasia. Obesity and genetic factors also play a role. Ultrasound during the third trimester to measure the child's head, femur and abdomen gives an indication of possible Macrosomia. A Leopold maneuver wherein the fetal weight is estimated by pushing the stomach through the abdomen is another diagnostic measure. Often a non-stress test is done to measure the baby's heart rate based on its movements. A cesarean delivery is usually conducted when macrosomia is noticed.
High Risk Pregnancy
A woman's medical status, lifestyle or external factors may be the cause for high risk pregnancy. Some complications are unavoidable, while the risk in some others can be minimized by the help of the gynecologist / physician. Many times complications can also occur without any warning signal. Sometimes causes and risk factors can be identified early and suitably treated.
Anemia in pregnancy: Anemia occurs when the red blood cells are too few in the body. This leads to a lowered ability of the red blood cells to carry oxygen. Since the fetus is dependant on the mother's blood anemia can cause poor fetal growth, pre term birth and low birth weight. Anemia of pregnancy, iron deficiency anemia, vitamin B 12 deficiency, anemia due to blood loss, folate deficiency anemia are some of the types of anemia during pregnancy.
Pre term labor: In high risk pregnancies more than 11% of the babies born are pre term. Pre term labor begins before completion of thirty seven weeks of pregnancy. Pre term labor may mean either uterine contractions, rupture of amniotic sac and/or cervical dilatation. Many factors can contribute to pre term labor. Some of the key factors are:
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Bibliography / Reference
Collection of Pages - Last revised Date: December 4, 2023