April 8, 2000
Gestational Diabetes
Question from Paducah, Kentucky, USA:
I am 35 years old and at 10 weeks into my previous pregnancy I was diagnosed with Gestational Diabetes. I was put on insulin then took the test after I had my son which I also failed so I was then put on oral medication for 3 years. I am pregnant again but prior to becoming pregnant my blood sugars were averaging 300+. My doctor has put me on insulin again and is still adjusting the dosage my fasting are running about 160-180 and during the day 200+. I have had a ultrasound already. I am 12 weeks and so far they said everything looked okay. Does this mean that my baby will not have defects? I am having great difficulty taking my injections (phobia of needles) and sticking to my diet. My previous pregnancy my baby weighed 8 pounds, 9 ounces, and was induced and I barely took my injections during that pregnancy. But this pregnancy I fear the worst. What tests can be done to assure me that my baby is all right?
Answer:
The fetus is fully formed at this time. Ultrasound is probably the most useful tool to evaluate the fetus at this time. There is some blood testing that is done at about 16 weeks to screen for neural tube defects (spina bifida) and chromosomal abnormalities. This is called a “maternal serum triple screen”. Another ultrasound will probably be done between 16 and 18 weeks to look over the baby and this can rule out some, but not all abnormalities. The baby’s heart should be examined by ultrasound at 20-24 weeks gestation. Once again this can rule out some but not every cardiac defect.
It is important that you improve your blood sugar control to prevent excessive growth of the baby and for your own well-being.
OWJ
