Diabetes and Pregnancy
Checking Your Baby’s Health During Pregnancy
You are likely to have tests all through your pregnancy to check your baby’s health. Your health care team can tell you which of the following tests you’ll have and when you might have them. Your health care provider might also suggest other tests. If certain diseases or conditions run in your family, you might meet with a genetic counselor. The counselor may recommend tests based on your family history and can explain the risk of certain conditions for your baby.
Maternal Blood Screening Test
The maternal blood screening test is also called the multiple marker screen test, the triple screen, or quad screen. It measures several substances in your blood. Results can tell you whether your baby is at risk for spinal cord and brain problems, Down syndrome, and other birth defects. If the results show an increased risk for problems, additional tests such as ultrasound or amniocentesis can provide more information.
Ultrasound uses sound waves to provide a picture of areas inside the body. The picture produced by ultrasound is called a sonogram. Ultrasound can show the baby’s size, position, structures, and sex. It can also help estimate age, evaluate growth, and show some types of birth defects.
The fetal echocardiogram uses ultrasound to check for problems in the structures of the baby’s heart.
Amniocentesis uses a thin needle inserted through the abdomen into the uterus to obtain a small amount of the fluid that surrounds the baby. Cells from the fluid are grown in a lab and then analyzed. Amniocentesis can help tell whether your baby has health problems and if your baby’s lungs have finished developing. Developed lungs are needed for the baby to breathe without help after delivery.
Chorionic Villus Sampling (CVS)
CVS involves a thin needle inserted into the placenta to obtain cells. Cells then are analyzed to look for health problems. Ultrasound is used to guide the needle into the placenta, either through the vagina and cervix or through the abdomen and uterus. The placenta is composed of tissue and blood vessels that develop to attach the baby to the mother’s uterus so the developing baby can get nutrition from mom.
Kick Counts (Fetal Movement Counting)
Counting kicks is an easy way to keep track of your baby’s activity. You’ll count how many times the baby moves during a certain period of time.
A fetal monitor checks whether your baby’s heart rate increases as it should when the baby is active.
Ultrasound checks your baby’s muscle tone, breathing, and movement to obtain a biophysical profile. Ultrasound also estimates the amount of amniotic fluid surrounding the baby.
Contraction Stress Test
This test measures the baby’s heart rate during contractions using a fetal monitor. The results can help your doctor decide whether the baby needs to be delivered early.
About Labor and Delivery
Timing of Delivery
Your health care team will consider your health, your baby’s health, and the state of your pregnancy in deciding how and when delivery should occur. Some doctors prefer to deliver babies of women with diabetes 1 or 2 weeks before their due dates to lower the risk of problems. Your doctor may recommend inducing labor before your due date or delivering the baby surgically using a cesarean section, also called a c-section. However, most women with diabetes have the option of delivering vaginally. You’ll want to talk with your health care team about your options well ahead of time.
The factors your health care team will consider in deciding what type of delivery is best for you and your baby may include
“I talked with my doctor way before I was due about my options for delivering my baby.”
Blood Glucose Control During Labor and Delivery
Keeping your blood glucose levels under control helps ensure your baby won’t have low blood glucose after birth. Because you’ll be physically active when you’re in labor, you may not need much insulin. Hospital staff will check your blood glucose levels frequently. Some women take both insulin and glucose, as well as fluids, through an intravenous (IV) line during labor. Infusing insulin and glucose directly into your bloodstream through a vein provides good control of blood glucose levels. If you are using an insulin pump, you might continue to use it throughout labor.
If you are having a c-section, your blood glucose levels may increase because of the stress of surgery. Your health care team will closely monitor your blood glucose levels and will likely use an IV for insulin and glucose to keep your levels under control.
After Your Baby Arrives
Breastfeeding is highly recommended for the babies of women with diabetes. Breastfeeding provides the best nutrition and helps your baby stay healthy.
“Even though I have diabetes, I can still breastfeed my baby. My milk gives my baby exactly what he needs.”
Your Meal Plan
If you’re breastfeeding, you might need more calories each day than you needed during your pregnancy. Your dietitian can provide personalized recommendations and answer any questions you have about what, when, and how much to eat.
After you’ve given birth, you might need less insulin than usual for several days. Breastfeeding can also lower the amount of insulin you need. Diabetes pills are not recommended during breastfeeding.
Low Blood Glucose
You’ll be at increased risk for low blood glucose, especially if you’re breastfeeding. You might need to have a snack before or after you breastfeed your baby. Your health care team may suggest that you check your blood glucose more often than usual.
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