Pregnancy and Diabetes: Risk Factors and Avoiding Complications
Birth Weight
Birth Defects
Death in-Utero and Death Following Birth
Health of the Diabetic Mother
Preventive Measures
Testing
Pre-Conception Counseling
Medical and Advisory Team
Pregnancy requires more insulin in the body than normal because of the increased production of hormones that can lead to insulin resistance.
For a woman suffering from type 1 diabetes this is especially problematic because she already has difficulty producing or responding to insulin. Not only is the mother's health at risk, but the baby's health may suffer as well. As insufficient insulin causes blood sugar to rise in the mother, the sugar travels across the placenta to the baby. When the baby's blood sugar is high, the baby makes extra insulin to keep its own blood sugar normal. Problems of the developing baby may include larger or smaller size, increased risk for malformations or birth defects, or death in-utero. Fortunately, there are several precautions that a woman can take to dramatically decrease the risk of complications.
Large and small birth-weight babies are a significant problem in the deliveries of diabetic mothers. Smaller than usual size typically occurs when the mother has had diabetes for several years and has changes in her blood vessels. On the other hand, the combination of high sugar and high insulin make cause the baby to grow larger than normal. Large birth weight, macrosomia, occurs two to three times more often in diabetic pregnancies as in the general population. Risks of fetal macrosomia include:
Injury to the nerves to the arm called brachial plexus palsy
The collar bone may break, called fractured clavicle
The baby may need more help breathing at birth because it took longer for the head and shoulders to come out.
The doctors may need to use forceps or a suction cup to help with delivery
Due to the increased risk of fetal macrosomia, women with diabetes are three to four times more likely to have a cesarean section.
If a diabetic woman does not receive preconception care to regulate blood sugar levels, the rate of major congenital malformations in women with preexisting diabetes is ten percent...
In cases where glycemic control is not achieved by dietary adjustments, commencing insulin therapy is strongly recommended. It is also essential to monitor the fetal health using ultrasound screening to avoid any complications during delivery of the baby. Regular monitoring of maternal glycemic levels and proper obstetric care should greatly help in reducing the potential health complications associated with diabetes during pregnancy. Bibliography 1) Alana Bluman Jincoe, (2006), 'Diabetes: Monitoring maternal
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This note discusses on certain complications pregnant women encounter during their pregnancy, labor and birth. Appropriate patient education is necessary in prepregnancy, ante partum, labor and delivery settings to address complications and risk factors that could harm the mother and infant during labor and birth. Several of these risk factors can be eliminated by proper patient education. Nurses are not simply health care providers and caregivers; they also functions as
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