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May 3, 2001

Family Planning

Question from Chennai, Tamilnadu, India:

I am 25 years old, have had type 1 diabetes for 13 years, have no complications, and recently lost a one month old baby who was delivered by C-section at 34 weeks gestation. During the pregnancy, I developed appendicitis and needed an emergency C-section since my blood pressure shot up, the fluid inside was drying, and the child was going into growth retardation (the sonogram showed approximately 30 weeks of growth). Since he was premature, and his system was not properly developed, even though the doctors tried to save him, they could not. My doctors are blaming my diabetes for the loss of my child. Is it true? I controlled my sugars during pregnancy. They never shot up, and yes, I had some hypos. I think from start itself some things or other went wrong. I couldn't eat properly during my pregnancy. In the US, doctors don' t give any medicine except Tylenol. but I had a lot of antibiotics as well as other tablets to kill my pain which I had due to appendix. My doctor too didn't know at that time that the pain was due to appendicitis. She thought it was due to an expanding uterus. At some stage, I made a mistake, and at some stage, doctors made mistakes. My obstetrician told me that this was my last chance to be mother since during my C- Section, I had seizures due to a very high blood pressure, and I was saved with great difficulty. Can I be a mother again? I want a baby badly, and my doctor tells it may cost my life if I have another child. I want a baby for sure. What precautions will I have to take so that I can save myself and have a healthy baby? When should I plan another baby?

Answer:

Your story is very complicated. It appears that you had appendicitis and then developed preeclampsia which required an early delivery. Both of these are resolved. You do have an increased risk of developing preeclampsia in subsequent pregnancies, but the risk is not huge (10-15%). Diabetes is an additional risk factor for preeclampsia. However, if your blood sugar is well controlled, and you do not have any complications from diabetes, particularly kidney disease then you should do well during a pregnancy. You should be cared for by a specialist in high risk pregnancies if at all possible.

OWJ