Complications in Pregnancy
Complications in Pregnancy
Rain on Your Parade
For the majority of women, pregnancy is a normal and physiologically uneventful process. You count on breezing through pregnancy with no problems, looking and feeling great. When complications arise, you’re forced to make adjustments in your idyllic pregnancy plan. It is not an easy adjustment for most women. Your self-esteem suffers. Disappointment and anger are common emotions as you struggle to deal with the unexpected events. You add anxiety and fear for you and your baby to the witch’s brew of unknowns facing you. You need expert care, added emotional support, and accurate information to cope effectively with the changes.
When you understand the basics, your anxiety decreases. When you’re calm, you’re better able to hear and understand what your doctor communicates to you. You’ll find that you can cope and maintain some control over the unanticipated events which altered your pregnancy plans. You don’t have to junk your original blueprint for your pregnancy; you just have to do some remodeling. For example, you can still enjoy and revel in the normal aspects of your pregnancy. You can feel the baby move, take childbirth classes, and shop for baby furniture. You’ll still experience those “normal” aches and pains of pregnancy along with every other pregnant woman. Only part of your pregnancy is complicated, not all of it!
Gestational Diabetes
Approximately 1 to 4 percent of pregnant women develop the condition known as gestational diabetes. What happens?
Pooped Pancreas
During the second trimester, the hormones of pregnancy are in full force. These hormones inhibit the effectiveness of insulin in the body. The pancreas, which produces insulin, has to work harder to produce more insulin to keep up with the increased demand. Most women are able to meet the increased demand; for those who can’t, a temporary state of diabetes results when the demand is greater than the supply of insulin.
Banking on Your Body
In the diabetic state, your body can’t effectively transact the business of converting the food you eat into energy. The food you eat can be considered energy checks that you deposit in your body bank. Insulin acts as the bank teller who converts your checks into available energy. Simple sugar is like cash for immediate energy; fat is stored as savings for emergencies; other sugar is stored as an easy access checking account. Insulin is the key to the system running efficiently and keeping you in funds. Without insulin, your assets are frozen. Your deposits don’t make it into your accounts, and you don’t have access to what’s already there. Your blood develops high levels of sugar but isn’t able to use it. It’s similar to having $1 million in a safety deposit box but not having the key to open it.
Good News
Unlike the type of diabetes that requires insulin; gestational diabetes is a temporary condition. After delivery, when the pregnancy hormones are gone, your body returns to its regular metabolism. Also, your baby doesn’t run the increased risk of developing congenital anomalies since gestational diabetes doesn’t develop until the second trimester. Let’s discuss some potential problems that do need to be anticipated.
Fit or Fat
The higher blood sugar levels you experience with gestational diabetes present some problems (or you and your baby. Your baby’s prime fuel is sugar. By 12 weeks she’s making her own insulin to handle the sugar you give her. Your blood sugar crosses the placenta very easily. When you have excess amounts in your bloodstream, it gravitates to the baby. Uncontrolled blood sugar levels that are chronically elevated pose big risks for your baby.
The chronically elevated blood sugar levels force-feed the baby; excessive weight and size result. The more your baby weighs the more potential problems for both of you during labor and delivery. For example, you may have no problem delivering an 8pound baby, but at 9 to 10 pounds there isn’t enough room. Birth injury to you and the baby is a possibility. Your chances for a cesarean birth increase. Jaundice and low blood sugar (hypoglycemia) are also common complications for the baby when blood sugar is uncontrolled during pregnancy. Detection and management of the condition are crucial for a successful pregnancy.
Detection and Treatment
The American College of Obstetrics and Gynecology (ACOG) recommends screening all pregnant women 30 and over and those who have risk factors for diabetes. Many experts believe that all pregnant women need screening at 24 to 28 weeks of pregnancy. Screening includes either ingesting a 50gram sugar drink or eating a meal high in carbohydrates. A blood sample is taken 1 to 2 hours later. Some doctors have sugar meters in their office and offer this test to their patients; it’s worth doing. These days, with early detection and appropriate management, many potential problems can be avoided.
Treatment of gestational diabetes is fairly simple. Your doctor will prescribe a diet from the American Diabetic Association (ADA). The diet controls your blood sugar, keeping it within safe levels. Most pregnant women are able to maintain their blood sugar with just the diet. It’s important to follow the diet if you want to avoid the problems discussed earlier. A reasonable exercise program also helps control blood sugar. If your blood sugar can’t be controlled with diet and exercise alone, insulin will be prescribed also. Remember, this metabolic condition is only a temporary one; with just a little extra effort on your part, you can assure that your baby will be healthy.
After Delivery
Half the women who develop gestational diabetes during pregnancy are at increased risk for diabetes in later life. So even if your metabolism returns to normal after delivery, you need follow-up. Developing diabetes in later life is associated with a family history of the disease, obesity, lack of exercise, and inappropriate diet. After pregnancy, resolve to continue the good eating habits you learned from your ADA diet, and continue exercising to lose unhealthy pounds. It will pay off in the future.
Insulin-Required Diabetes
For those of you who are diabetics and regularly use insulin, there’s also good news. The outcomes for women with diabetes and their babies is the best it has ever been. With well-controlled sugar levels during pregnancy, you can expect and have a healthy baby!
Management of insulin-required diabetes in pregnancy has become more efficient, less costly, and less disrupting to your life-style than it used to be. Monitoring sugar levels at home gives you more control and the consistent feedback you need to keep your blood sugar levels consistently within safe limits.
To assure the best outcome possible for your planned baby, see your internist, obstetrician, or perinatologist before you get pregnant. Achieving the best control possible before conception lowers the risks for congenital anomalies. By the time you realize you’re pregnant, it may be too late since the anomalies occur in the first trimester. Get an early start on prevention.