Gestational Diabetes…Optional Testing During Pregnancy

Gestational Diabetes…
Optional Testing During Pregnancy

By Valerie Jacques, RN, CPM, NHCM

This is the second in a series of articles exploring testing procedures available for you and your baby during pregnancy.

Gestational diabetes is a form of the disease, which manifests itself in 2% to 5% of pregnant woman (only occurring during pregnancy). As with other forms of diabetes, the body is unable to effectively use glucose (a simple sugar that your body converts into energy). Normally, glucose is used by the cells of your body with the help of insulin (a hormone produced by the pancreas).

In the case of the pregnant Mom, insulin is blocked from doing its intended job by certain pregnancy hormones. When this happens, glucose builds up in Mom’s blood, and if not treated, can harm both Mom and baby. The risks associated with gestational diabetes include:
· Newborn hypoglycemia - low blood sugar in your baby
· Jaundice - your baby has a yellowish skin tone, which is associated with a buildup of red bile pigment (bilirubin) in his/her bloodstream.
· High blood pressure (Mom)
· Premature birth
· Macrosomia - birthing a very large baby (10 pounds or more), which occurs because your baby was exposed to high glucose levels in your body and has stored the glucose as fat.
· Birth trauma (for Mom and baby) – due to birthing a large baby
· Miscarriage
· Birth defects (rare)
· Stillbirth (rare)

Gestational diabetes usually manifests itself about halfway through the pregnancy, therefore the test for the disease is generally administered between 24 and 28 weeks into the pregnancy. The test requires Mom to give a blood sample, which is analyzed for glucose content. If the initial test is positive, it may be necessary to conduct a second, more sensitive test for the disease.

There may be no apparent symptoms prior to testing for the disease, therefore it important to have screening. If symptoms do occur however, they may include the following: increased thirst, increased urination, fatigue, nausea, vomiting, blurred vision and frequent infections (especially bladder, vaginal and skin infections).

Risk factors for gestational diabetes include: history of diabetes in your family, a previous pregnancy with gestational diabetes, age (Mom is over 25 years old), weight (Mom was overweight before becoming pregnant), having glucose present in Mom’s urine (glucosuria), hypertension, having too much amniotic fluid (polyhydramnios), having given birth previously to a very large baby, stillbirth, and race (Black, Hispanic, and Indian women are at more risk…the reasons are yet unclear).

Treatment consists of controlling the level of glucose in Mom’s bloodstream, and is essential in order to keep Mom and her baby healthy. The good new is that most Moms are able to control their blood sugar with diet and exercise. In some cases, however lifestyle changes and/or medication may be necessary in addition. If Mom is diagnosed with gestational diabetes, it will be necessary to monitor the level of glucose in her blood closely for the balance of the pregnancy, assuring that levels are staying in the normal range.

The more informed you are, the better prepared you will be to make decisions regarding your health and the health of your baby. For more information on these and other tests during pregnancy, speak with your health provider. Also, look for more information contained in the Informed Consent Agreement provided by your health professional. Knowledge is power.

Valerie Jacques is a NH Certified Midwife, a Certified Professional Midwife, an RN, and the owner/operator of Coastal Family Birth Retreat in Stratham, NH. She can be reached at 603-502-9452, or at www.coastalfamilybirthretreat.com.