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Diabetes mellitus and pregnancy
For women with diabetes mellitus, pregnancy can present some particular challenges for both mother and child. If the woman who is pregnant has diabetes or develops diabetes during pregnancy, it can cause early labor, birth defects, and very large babies.
Additional recommended knowledge
During a normal pregnancy, a lot of physiological changes occur that influence blood glucose levels, such as a glucose-'drain' to the fetus, slowed emptying of the stomach, increased excretion of glucose by the kidneys and resistance of cells to insulin.
Risks for the child
Miscarriage, growth restriction, growth acceleration, fetal obesity (macrosomia), polyhydramnios. Birth defects are not currently an identified risk for the child of women with gestational diabetes.
Risks for the mother
Disturbed blood glucose levels. Hypoglycaemia can occur without warning.
The White classification, named after Priscilla White who pioneered in research on the effect of diabetes types on perinatal outcome, is widely used to assess maternal and fetal risk. It distinguishes between gestational diabetes (type A) and diabetes that existed prior to pregnancy (pregestational diabetes). These two groups are further subdivided according to their associated risks and management.
There are 2 subtypes of gestational diabetes (diabetes which began during pregnancy):
The second group of diabetes which existed prior to pregnancy can be split up into these subtypes:
An early age of onset or long-standing disease comes with greater risks, hence the first three subtypes.
Treatment of pregnant women with diabetes
Blood glucose levels in the pregnant woman should be regulated as strictly as possible. In diabetes mellitus type 2, oral antidiabetic drugs should be replaced with insulin.
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Diabetes_mellitus_and_pregnancy". A list of authors is available in Wikipedia.|