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Careful care

As an expectant mom, you know your body is going through a lot of changes, and you’re working hard to take care of it. You take vitamins, eat right, get plenty of sleep, and have familiarized yourself with your family’s history when it comes to diseases. But you’re not out of the woods yet—some serious...

As an expectant mom, you know your body is going through a lot of changes, and you’re working hard to take care of it. You take vitamins, eat right, get plenty of sleep, and have familiarized yourself with your family’s history when it comes to diseases. But you’re not out of the woods yet—some serious prenatal complications can occur in women who haven’t previously suffered major health issues. Here’s what you need to know about two common pregnancy complications to keep you and your baby in tip-top shape.
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Gestational diabetes is one of the most frequent health problems associated with pregnancy, affecting between 2 and 10 percent of women. It’s not limited to women who were diagnosed with diabetes before their pregnancy or to those who have a family history of diabetes—any pregnant woman is a candidate.
Ordinarily, your pancreas produces a chemical called insulin, which your body uses to break down the glucose in sugar to use as fuel. However, the hormonal changes that come with pregnancy make your cells less responsive to insulin. A healthy pancreas can respond by simply producing more insulin, but when it can’t, your bloodstream gets filled with too much glucose and results in gestational diabetes.
“Women are typically given a glucose test between 24 and 28 weeks into their pregnancy,” says Kecia Gaither, MD, director of maternal fetal medicine at Brookdale University Hospital and Medical Center in New York. “It’s a simple test that takes one hour. If the results are abnormal, she’ll be given a more in-depth, three-hour long test, which will test her blood sugar four times.” If the results of the second test indicate a high blood sugar level, she’ll be diagnosed with gestational diabetes.
Though many women with gestational diabetes can control the problem with diet and exercise and usually go on to have healthy babies, others have more serious cases. “Some doctors will prescribe medicine, typically either oral glucose or insulin,” says Gaither. The problem also affects the baby. Frequently, the excess sugar in the mother’s blood causes the baby to put on weight, sometimes making the baby too big for the birth canal. Not only can this lead to complications during birth, it can also lead to the child remaining overweight through childhood or into adulthood.
Baby’s body may also try to compensate for the glucose in his mother’s bloodstream by producing extra insulin. Shortly after birth, baby might continue producing extra insulin, leading to hypoglycemia (low blood sugar). This can usually be corrected by feeding your newborn as soon as possible after delivery, but in rare cases, severe hypoglycemia can lead to seizures, coma or brain damage. Fortunately, putting baby on an IV drip of glucose can often prevent such outcomes, and your delivery team will test your infant’s blood sugar to determine if an IV is necessary. The lungs of babies of mothers with gestational diabetes also develop later, sometimes resulting in breathing problems and occasionally a higher risk of jaundice.
Under pressure
Women with gestational diabetes, particularly those who are obese or have not controlled their blood sugar levels, are also at an increased risk for gestational hypertension or preeclampsia. Gestational hypertension is high blood pressure brought on by pregnancy. When a mother has gestational hypertension and also has protein in her urine, she is diagnosed with preeclampsia.
Most cases of preeclampsia are relatively mild and result in healthy babies, but cases that begin early can have a serious effect on the baby’s development. When a mother’s blood vessels constrict, it results in lower blood flow. This can be dangerous to both mom and baby since blood flow to important organs, including the liver, kidneys, brain or uterus, can be cut off. When the uterus is deprived of blood, it can result in poor growth and development of the baby, too little amniotic fluid, or even cause separation of the placenta from the uterine wall. If the condition persists, it can lead to seizures known as eclampsia.
“When a woman is diagnosed with pre-eclampsia, she’ll be given a classification of either mild or severe,” says Gaither. “If it’s a mild case, she’ll be put on bed rest under close watch, preferably in the hospital. If it’s severe, the doctor will need to deliver the baby immediately, regardless of term length.”
Luckily, in most cases both gestational diabetes and preeclampsia go away after giving birth, and both the mother and baby generally make a full recovery. For this reason, if you are diagnosed with either condition, your doctor may choose to induce birth early, either vaginally or via caesarean. Gaither’s best advice for pregnant women? “Early prenatal care, early prenatal care, early prenatal care! I can’t say it enough!” If you are pregnant or trying to become pregnant, talk to your doctor about your risk level and form a plan for minimizing potential complications.