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Gestational Diabetes (fetal risk)

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Gestational diabetes-comprehensive includes risk to fetus:medstudents:"The effects of diabetes on the fetus and infant can be considerable, especially in uncontrolled diabetes. There is an increase in fetal abnormalities such as neural tube defects. Macrosomia is common, and the perinatal death rate is higher than normal. The newborn may show hypocalcemia and hypoglycemia( not hyperglycemia). The insulin secretion that has been stimulated in the fetus by the high levels glucose from the mother continues after birth and can drop the newborn blood glucose to dangerously low levels"
http://www.medstudents.com.br/ginob/ginob4.htm#test1

What effect does gestational diabetes have on the fetus?:iqhealth:"While gestational diabetes that remains uncontrolled can have harmful effects on your baby, in most instances the complications and harmful effects of gestational diabetes are manageable and preventable. The key to avoiding problems in the fetus is in controlling blood glucose levels as soon as the woman is aware that she has gestational diabetes. If blood glucose levels continue to remain elevated, the fetus will develop a condition called "macrosomia." Macrosomia means "large body" and refers to a baby that is much larger than normal. Macrosomia occurs when maternal blood glucose levels remain elevated, allowing blood glucose to cross the placenta and enter the bloodstream of the fetus. When this occurs, the fetus responds by producing more insulin in an attempt to lower its own blood glucose levels. The fetus then converts the extra sugar that it has received into fat stores. Additional fat stores result in excess weight gain in the fetus."
http://atoz.iqhealth.com/atoz/Gestational/fetus.html

Possible complications for the baby:UNIVERSITY OF MARYLAND MEDICINE:"Unlike type 1 diabetes, gestational diabetes generally does not cause birth defects. Birth defects usually originate sometime during the first trimester (before the 13th week) of pregnancy. But, the insulin resistance from the contra-insulin hormones produced by the placenta does not usually occur until approximately the 24th week. Women with gestational diabetes generally have normal blood sugar levels during the critical first trimester"
http://www.umm.edu/diabetes-info/gesta.htm

Fetal response to excercise as an alternative treatment for gestational diabetes:The Physician and Sportsmedicine:"A primary concern regarding exercise during pregnancy is the potential risk to the fetus. Although risk of fetal injury has not been demonstrated, data are insufficient to support or discount this possibility--particularly in women with gestational diabetes--so exercise recommendations must be made cautiously. Hyperthermia is of special concern during pregnancy because the fetus has limited ability to dissipate heat. Pregnant women should be cautioned not to exercise in hot, humid weather or when they have a fever. In nonpregnant women, 30 to 60 minutes of strenuous exercise in adverse conditions can increase the core temperature to 38C, but strenuous exercise for 15 to 20 minutes in any condition usually will not increase temperature above 38C. Moderate exercise tempered with common sense, therefore, is unlikely to cause teratogenic effects from hyperthermia. However, hyperthermia during embryogenesis could lead to birth defects that are common among infants of women who have gestational diabetes"
http://www.physsportsmed.com/issues/1996/03_96/artal.htm

Effects of gestational diabetes during pregnancy:University of Michigan Health System:"The risk of problems during pregnancy is greatest when diabetes is not well controlled. Some of these problems may increase the chance of a cesarean delivery. This is why you need good blood sugar control during pregnancy. Good control of glucose levels, before and during pregnancy, can lower the risks. If you are at risk of developing gestational diabetes, you should understand the problems that may arise: Birth defects--such as heart defects, kidney problems, and spinal defects--occur more often in babies of women whose diabetes was not well controlled before pregnancy. Macrosomia (very large baby) occurs when the mother's blood sugar level is high. This allows too much sugar to go to the fetus. It can cause the fetus to grow too large. A too large baby is not always good and can make delivery difficult. For example, there may be problems delivering the baby's shoulders"
http://www.smartmoms.org/prenatal-tests/test4.html

What effect does gestational diabetes have on the fetus?:healthatoz:"Infants born to mothers with gestational diabetes are at increased risk for developing low blood glucose levels after birth. This occurs when the mother has had high glucose levels, causing the fetus to produce excess insulin, which may still be present at birth. After delivery, the infant no longer has excess blood glucose from the mother, but may still have high levels of circulating insulin. Blood glucose levels are closely monitored in the infant following birth, and extra glucose can be given to the infant when needed. Infants born to mothers with gestational diabetes can develop other chemical imbalances in the blood, but careful monitoring can detect these, allowing for early intervention when needed"
http://www.healthatoz.com/atoz/Gestational/fetus.html

What are the possible complications to the fetus?:Discovery Health:"Complications for the baby include: macrosomia, which means having a large body polyhydramnios, or excessive amniotic fluid increased incidence of birth defects premature delivery increased risk of miscarriage hypoglycemia, or low blood sugar levels at birth hypocalcemia, or low calcium levels at birth polycythemia, or too many red blood cells at birth"
http://health.discovery.com/diseasesandcond/encyclopedia/2025.html

Gestational Diabetes Effects on the fetus:behavemed.com:"A pregnant woman's blood travels through the placenta to her fetus. If the woman's blood glucose levels stay within a safe range, the fetus is at no greater risk for problems than a fetus whose mother does not have gestational diabetes. If a woman's blood glucose levels are above the safe range, the fetus's blood will also contain high levels of glucose. The fetus's body changes some of the extra glucose into fat, causing the fetus to grow larger than expected"
http://www.behavemed.com/kbase/topic/major/hw197466/course.htm

Gestational Diabetes Part 2: Risks & Treatment:nursing.about.com:"Infants born to mothers with uncontrolled gestational diabetes have a high risk of developing macrosomia (unusual largeness). This occurs because: The mother's glucose crosses the placenta to the fetus; The fetus makes more insulin to handle the extra glucose; and The extra glucose gets stored as fat and the fetus becomes larger. The fetus can become so large that vaginal delivery is impossible and a cesarean section must be performed. Extreme hyperglycemia can also lead to emergency delivery from fetal distress and even fetal death."
http://nursing.about.com/library/weekly/aa072402b.htm

Risk to Mother and the baby:diabetes.ca:"The risks to the infant include: macrosomia (large, fat baby); shoulder dystocia (birth trauma); and neonatal hypoglycemia (low blood sugar in the newborn); long-range implications are an increased risk for obesity and diabetes; prolonged newborn jaundice; low blood calcium; and respiratory distress syndrome"
http://www.diabetes.ca/Section_About/gestational.asp#9

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Gestational Diabetes and The Newborn Baby:familyinternet:"If gestational diabetes is diagnosed and blood sugar is well controlled, the baby is not at increased risk for complications of birth. However, if blood glucose levels are poorly controlled during the pregnancy, the baby has an increased risk of problems. The baby is at increased risk for stillbirth and newborn death. The newborn baby of the uncontrolled diabetic mother is quite likely to be large (called macrosomia and defined as greater than 4500 grams or 9 pounds). These babies appear quite plump. The large size increases the risk that the baby will be injured during the birth process, which requires lots of squeezing through a small space. In addition, they are more likely to suffer fetal distress during birth. During delivery, the baby is monitored carefully."
http://www.familyinternet.com/fisites/pregcom/03080070.htm#newborn



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Last updated by Andrew Lopez, RN on Wednesday, September 29, 2010


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