Gestational Diabetes

A few days ago a girlfriend of mine went to the doctors to take a dreaded test... the glucose tolerance test.  The glucose tolerance test is done around the 26th to 28th week of pregnancy.  If your doctor has reason, such as history of diabetes or pre pregnancy weight being very high, the test will be done prior to the 13th week and repeated at 28 weeks.  A glucose tolerance test is done to see if you have gestational diabetes.  Some people think that if you have diabetes you are overweight.  That is not necessarily the case.  She only weighs 138 pounds at almost 30 weeks gestation.  She was asking me a slew of questions because it wasn’t clearly explained to her through her doctor and her first test came back a bit high.  She wanted to know: What exactly is gestational diabetes? Will this hurt the baby? Am I going to have diabetes after pregnancy? Do I need insulin? How did I get this? Do I need to lose weight? Am I going to be able to deliver the baby naturally? Could the test have been wrong!  With all these questions being asked by her, I figured many other women would have the same questions.  I know I did when I was pregnant and I learned from extensive research through my studies and doctors.  

Gestational diabetes is high blood sugar levels during pregnancy.  It is tested by getting a blood draw, drinking a sugary, syrupy substance, then waiting an hour and getting more blood drawn.  The body absorbs the glucose very quickly which causes the blood glucose levels to raise within the hour you are waiting.  The blood is taken to measure how well the body has processed this overdose of glucose.  Every state has a different “norm” for the blood glucose level.  Some state say if your number comes back less than 140mg/dL form the 1 hour glucose screening you are in the clear.  Where we are, the blood glucose level is supposed to be less than 130mg/dL.  If in the event your number comes back high, chances are your doctor or midwife will order to have a 3 hour glucose screening done.  The 3 hour test is a bit more intolerable than the 1 hour.  You must fast from midnight to when the test is done, you get blood drawn at the fasting point to see what the levels are, then drink, wait an hour and blood gets drawn again, then do this 2 more times.  Your office will give you the exact instructions if you need to do this screening.

There is no EXACT cause for gestational diabetes, but it is known that the placenta, which is a source of your baby’s growth, does alter the way your body uses insulin when you have gestational diabetes.  If your body can not properly use and create insulin then it can lead to greater issues like hyperglycemia.  

Gestational diabetes can cause harm to your baby IF it is not properly monitored with intense cases. With gestational diabetes, any extra glucose will go through the placenta.  This will give the baby high blood glucose levels causing the baby to have extra insulin, more than necessary for their little bodies to grow, it will store as fat, leading to an overweight baby.

For most women, you will be put on a strict diet to keep your numbers down and all is good.  You may or may not end up going in for an induction do keep the baby from getting too big.  It depends on your doctor or midwife and what they feel is best.  More than not, all is fine and you will have your gorgeous healthy baby at the proper gestation.  So many women mistake induction for a c-section, they are different, and just because you may be induced does not mean you need to have a section.

I hope this answered some of your questions and helps to keep you informed!  Stay healthy, eat right, exercise and enjoy being pregnant! From this point on, it is over before you know it.

Keep It Down!

I want to discuss pregnancy induced hypertension (PIH).  It is something that is not necessarily a main concern initially when you are going through your prenatal visits.  It becomes a greater issue typically in the third trimester.  Questions I have been asked recently because of my experience are, “What is gestational hypertension?” “What is pregnancy induced hypertension?” What is preeclampsia?” “How do you get it?” “How can I prevent it?” “How will I know if I have it?”  I am going to answer all these questions and then some.

Hypertension is high blood pressure.  Blood pressure is the pressure of blood pushing against blood vessel walls.  When the force of the blood is above normal (120/80) this is considered high blood pressure.  Pregnancy induced hypertension (PIH) is high blood pressure accompanied by headaches, swelling in the face, feet and hands and protein in your urine.  PIH is also called preeclampsia, and toxemia.

There are certain factors that make you more at risk for PIH.  Being under the age of 20 or over the age of 35, being underweight or overweight, a history of hypertension, a history of PIH, a mother, sister, aunt or grandmother with a history of PIH or hypertension, kidney disease, immune disorder, and expecting multiples are all reasons you may be at higher risk.

If you experience any of the following immediately call your doctor or midwife:

-Swelling in the face, feet and/or hands

-Severe headaches accompanied by spots, dizziness and changes in vision

-Reduced urination or blood in the urine

-Flank or abdominal pain

-Vomiting and nausea

-Decreased fetal movement

These are all symptoms of PIH.

When you go to your prenatal visits your doctor or midwife will most likely take a urine sample and be testing routinely to see if there is any protein in your urine.  At every visit they also will check your blood pressure and weight.  If you have rapid weight gain, a high blood pressure and protein in the urine your doctor will order further testing for you and the baby.  There is question of high blood pressure when the systolic (above number) is between 120 and 139 and the diastolic (below number) is between 80 and 89, this is considered prehypertension.  Sometimes “office anxiety” kicks in and you temporarily have a higher read so in some cases it is best to ask your doctor to do another reading.  I had to get mine read at the beginning and end of my doctor appointments.

If PIH begins to get worse the only cure is to deliver the baby.  I remember being admitted to the hospital at 34 weeks and I was given magnesium to prevent any seizures and medication for the blood pressure.  At this point doctors and midwives need to look and see if the benefits outweigh the risk of using medication.  Make sure you do not hesitate to call your doctor or midwife if you are experiencing any of the above symptoms.

Rest Up Momma!

          There are many women that experience bed rest during pregnancy whether for a week or 3 months.  I was one of the “lucky ducklings” that was put on bed rest.  I had a few mommas e-mail me questions about my experience and if I found bed rest really helped.  I am going to start off by telling you that though I was prescribed bed rest, I did take occasional breaks.  Majority of the time I was not up and about, whether laying or sitting I was resting, but I would go for ride in the car just to get out and get some fresh air.  Research has not shown enough evidence that bed rest is beneficial for you and your baby; however, there isn’t research enough to prove that is isn’t.  Due to my experience with bed rest and my medical background, I just want to educate you a bit on bed rest.  I know so many expecting moms are faced with this and my hope is to let you know some pros, cons, risks, and benefits.

          Bed rest may be prescribed for the following reasons:
Pregnancy Induced Hypertension/Preeclampsia/Toxemia - For these conditions the only real cure is delivery.  I experience preeclampsia myself and thankfully had reached 37 weeks and was able to deliver.  If you have not reached the 37 week mark a doctor or midwife may prescribe bedrest so they can keep close watch on you.
Placenta Complications:
-Placenta Previa - When a woman has placenta previa this means the placenta has blocked the cervix not allowing the baby to exit.  Placenta previa can correct itself in some cases, but women may be put on bed rest to keep the pressure off the placenta and cervix.
-Placenta Abruption - This is when the placenta begins to separate form the uterine wall prior to delivery.
Cervical Insufficiency -  Cervical insufficiency means your cervix has begun dilating and effacing before your baby is full term and ready for delivery. With this condition there are no normally no symptoms.  Bed rest takes the pressure of your growing baby off the cervix.
Preterm Labor - If you are in preterm labor your body is ready to deliver the baby before the baby has reached full term.  There are many factors that can increase your risk of preterm labor such as:
-Smoking
-Alcohol Abuse
-Drug Abuse
-Health Conditions- preeclampsia, gestational diabetes, infections, blood clotting disorders
-History of preterm labor
-Having twins or multiple babies
-In vitro pregnancy
If you begin to experience contractions that are 10 minutes apart consistently, backache, increased vaginal pressure, cramping, gush of fluid, or any bleeding call your doctor or midwife because these are possible signs of preterm labor.

          By reducing activity and being put on bed rest there is a hope that the risk of preterm delivery or pregnancy complications will be reduced.  There are risks that can develop while on bed rest such as: blood clots, depression, anxiety, decreased birth-weight of your baby, difficulty delivering due to weakened bones and muscles, and slower recovery after birth.

          If you are prescribed bed rest you want to make sure you are getting a full explanation of what bed rest means to your doctor.  There are different degrees of bed rest so make sure you are asking the appropriate questions to be sure you are getting the proper information.  To keep yourself in the know here are some good questions you could ask your doctor or midwife.  What reasons are you recommending bed rest?  What degree of bed rest is appropriate?  What are the benefits for my baby and me? Do the benefits outweigh the risks?  What are some potential issues from bed rest for my baby and for me?  How long will I be on bed rest?  Can I do normal household chores? Can I take care of my other kids?  Is it best to lie on one side over the other?  Is it alright to continue sexual activity? If so, are certain positions safer than others?  If you don’t feel your questions have been answered to your satisfaction or feel uneasy it can not hurt to get a second opinion.

          Some research has shown that resuming your everyday activity to a lesser degree would be more beneficial for you than strict bed rest.  As I said before there are different degrees of bed rest.  Bed rest for a few hours a day while still resuming other activities to a lesser degree, bed rest which confines you to only activity in the home, and bed rest which means you are in bed only.  It is up to you and your doctor or midwife but make sure you feel comfortable with the decisions made.

           If you are prescribed bedrest and are limited to little or no activity it can be extremely difficult mentally.  It is important to give yourself some ways to pass the time productively, otherwise you will go insane.  I found myself going nuts throughout the day because I was alone and unable to drive or do anything.  Thank God for candy crush!  Have some friends come over and keep you company, even if just for an hour to watch a movie, it will make a big difference.  Use the time to bond with your baby, play music for him or her and talk to your baby, he or she can hear everything and is getting to know you.  Take the time to learn a new hobby like knitting.  Keep a journal of all your experiences, when the baby moves, how the baby reacts to certain things.

In my own experience I found bed rest to be both helpful but also not.  As I said before it is what you and your doctor or midwife decide and what is best for you and your baby.  I hope this helped educate you a bit about bed rest.  If you have any questions please feel free to contact me at helpingmommytone@gmail.com.