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LIST OF PROBLEMS
RPL
Cervical Insufficiency
High Blood Pressure
Diabetes and Gestational Diabetes
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Perinatal Problems
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Gestational Diabetes:

Diabetes that develops during pregnancy is called Gestational Diabetes and affects at least 5% of pregnant women. For some women, the diabetes may persist after delivery and becomes Type II. 

The test for gestational diabetes is usually done between 26-28 weeks of pregnancy and involves drinking a sweetened sugar solution and then measuring the blood glucose level one hour later. If that value is found to be high, a 3-hour glucose test is performed, and if the result of that test is abnormal, the diagnosis of gestational diabetes is made.  Women who have had gestational diabetes have at least 50 percent chance of developing Type II Diabetes later in life.

Preexisting Diabetes:

Almost 6% of the US population has Diabetes Mellitus.  Diabetes can either be Type I which is also known as Juvenile or Insulin Dependent diabetes, or it can be Type II which is also known as adult onset or Non-Insulin dependent diabetes. 

Diabetes is becoming more prevalent and many more women are being affected, especially during their reproductive years.  Diabetes during pregnancy is more difficult to control than in non-pregnant women because of the effect of the hormones produced by the placenta, which interfere with the way insulin works.

How is Diabetes in Pregnancy Managed?
If you are diagnosed with Diabetes during your pregnancy, or if you are Diabetic before becoming pregnant, you will be referred for consultation with a High Risk Obstetrician (Perinatologist) experienced in the management of diabetes in pregnancy, in addition to a Diabetic Educator and a Dietician.  The management of diabetes in pregnancy, whether gestational, Type I or Type II includes strict blood sugar control with diet, monitoring blood sugar levels, and medication as required. Serial ultrasound evaluation is done to assess your baby’s growth, in addition to tests which measure your baby’s well-being such as the Biophysical Profile (BPP) or Non-Stress Test (NST)

The management of gestational diabetes includes strict blood sugar control first with diet in addition to monitoring blood sugar levels with finger sticks. Medication to control blood sugar will be added if diet alone doesn’t control your blood sugar; in that case oral pills (Glyburide) and sometimes Insulin injections may become necessary. Tests of fetal well being such as the Biophysical Profile (BPP) or Non-Stress Test (NST) are done in the third trimester.

Most Type II Diabetic mothers and all Type I Diabetic mothers need Insulin to regulate their blood sugars. 

The management of a pregnant diabetic woman demands team work which includes a High Risk Obstetrician (Perinatologist) experienced in the management of diabetes in pregnancy, your Obstetrician, a Diabetic Educator, a Dietician, and an Endocrinologist especially if you have Type I.

To ensure delivering a healthy baby if you are Type I or II we would recommend first trimester ultrasound (11-14 weeks) for Nuchal translucency measurement, Anomaly scan (Targeted scan or Level II) at 20 weeks, Fetal Echocardiogram (Specialized ultrasound for the Baby’s heat at 22-24 weeks), followed by  serial ultrasound evaluations for fetal growth  As mentioned above,  in addition tests which measure your baby’s well-being are essential, such as the Biophysical Profile (BPP) or Non-Stress Test (NST), and are done twice weekly in the third trimester as early as 30 weeks.  

Our High Risk Doctors are experts and have extensive experience in the management of Diabetes in pregnancy.

 

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