Diabetes in Pregnant Women

A hundred years ago many children died of illness before reaching adulthood. Better treatment is allowing most of them to survive now, and among them are less robust young women, many of whom have children. These women cause special problems for the obstetrician and make up a great deal of his antenatal work. By careful control of the pregnancy most of these women carry throgh normally and bear normal children, usually by a natural delivery. In order to ensure this, constant vivilance is required throughout pregnancy and much patience is often needed on the part of the mothe while undergoing treatments that appear boring and pointless to her at the time. She must remember that these very treatments have brought many women with conditions similar to her own through to a safe delivery. The incidental conditions, some serious and others trivial, will be dealt with in turn.

With the advent of insulin in 1924, diabetics were given the chance to lead normal lives. The likelihood of a diabetic now becoming pregnant is almost as good as for any other woman and, with special care, a normal infant is produced.

This is a great contrast with the situation thirty to forty years ago when diabetic patients rarely became pregnant and, if they did so, were in grave danger of losing the infants', if not their own lives.

Hospital Care

A diabetic woman who becomes pregnant should attend the ante-natal clinic of a hospital that is used to dealing with such cases. The blood-sugar levels will have to be checked frequently as the urine tests may be misleading. A high carbohydrate diet (about 300 grammes per day) is advisable and the insulin dosage will have to be watched carefully.

Because of the increased risk to the baby, a pregnant diabetic woman should be admitted to hospital in the seventh or eighth month and the infant may be delivered before full term, if necessary by operation. These methods have been shown to produce the best chance for the baby. After delivery it is common for the diabetic condition to be temporarily improved and the dose of insulin must again be watched carefully.

The babies of diabetic women are usually big and tend to lose a lot of weight in the first week. This is usual and need not worry the mother. Feeding of the infant is likely to be normal.

Source : Family Physician

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