COMPLICATIONS

I have read that mothers with diabetes are more likely to have babies with congenital malformations. I am thinking of a pregnancy but am terrified of having a child with an abnormality. What can I do to prevent this?

It is true that there is an association between diabetes in the mother and congenital abnormalities in her baby. We know that the most important factor influencing this is the control of the diabetes. If the HbA1c is less than 7.5% at conception, the risk of congenital abnormalities health and care mall is similar to that of mothers without diabetes. The higher the HbA1c, the greater the risk to the development of the baby. Therefore the best thing for you to do is to make sure that your diabetes is well controlled before you conceive.

Some women with diabetes take regular medication to protect them from kidney and heart disease. These drugs can cause damage to the baby and should be stopped before you conceive. If you are uncertain about your medication you should discuss this with your doctor.

There is good evidence that taking folic acid supplements before conception protects against abnormalities such as spina bifida and in people with diabetes the higher dose of 5 mg is recommended. Your doctor will prescribe this for you.

All pregnant women are offered a blood test known as the triple test to screen for abnormalities such as Down’s syndrome and spina bifida. This is carried out at 16 weeks and if abnormal, further tests will be offered to identify the problem. If these confirm an abnormality, your doctors will discuss the implications with you, and you may decide to have a termination. Canadian health care mall online.

Women with diabetes are also offered an abnormality scan at 20 weeks and this may be followed up with a detailed cardiac scan to identify any heart problems. If an abnormality is detected this will be discussed with you and a termination may be offered.

I developed toxaemia during my last pregnancy and had to spend several weeks in hospital even though control of my diabetes was immaculate. Luckily everything turned out all right and I now have a beautiful healthy son. Was the toxaemia related to me having diabetes? Is it likely to recur in future pregnancies?

Women with diabetes are more prone to toxaemia (pre-eclampsia). You are not more likely to develop toxaemia in your future pregnancies – indeed the risk is lower than in your first pregnancy health and care pharmacy

During the recent delivery of my fourth child (which went very smoothly) I had an insulin pump into a vein during labour. I had not had this in my previous three pregnancies, despite having diabetes. Why did I need the pump this time?

We now know that it is very important to keep your blood glucose within normal limits during labour to minimise the risk of your baby developing a low blood glucose (hypoglycaemia) in the first few hours after birth. This is most effectively and easily done using an intravenous insulin infusion combined with some glucose given as an intravenous drip. Using this method, your blood glucose can be kept strictly regulated at the normal level until your baby has been delivered. It also ensures that if any complications arise, an anaesthetic can be given without further preparation.

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