Diabetes in the pregnancy

Women who suffer "diabetes mellitus" at the metabolic disease can take healthy children to the world at an optimal metabolism attitude nowadays, too. Is very important that the women have blood sugar values already adjusted correctly before the beginning of the pregnancy. The not planned pregnancies represent a problem (30-40 %) with diabetics.

Risks at badly adjusted blood-sugar level

The increased blood-sugar level at the mother gets (for example heart out and renal malformations) lead to diabetes typical malformations with the child already as of the 5th pregnancy week. Further effects at a bad blood sugar attitude are: increased am missing and premature deliveries, placental insufficiency, of increased fetus water quantity (hydramnion) and excessive growth of the unborn at simultaneously delayed lung maturity. The children can weigh gram more than 4500.

A too high blood-sugar level of the mother leads resulting also at the unborn one to a high sugar content of the blood and from this to a tense insulin production of the pancreas of the fetus. The organs of the child are it more unripely than one often suspects from their size. Adaptation disturbances very often result from it with the newborn child, like too low blood sugar content, too high bilirubin content and an acidosis. After the birth the baby immediately should medical be looked and treated if necessary.

Insulin need

It is a topmost aim to hire the diabetic optimally. To this, perhaps the treating physician will order an insulin pump. Oral antidiabetics are removed. The diet specific for the diabetic illness has to be observed strictly. The insulin need usually doesn't change within the first weeks of the pregnancy. It can decrease even a little within the first three months. As of the 22nd to 26 pregnancy week it rises constantly. Until the 36th pregnancy week it even doubles. With using the labors the insulin need sinks drastically.

The pregnant woman should be conscious that there is an increased need for insulin at infections and stress. The blood-sugar level should be checked hourly and be reacted depending on results during the birth. In the first week after the birth the insulin mirror lies more lowly than in front of the pregnancy. It reaches the original values three to four weeks after the birth.

Check-ups

The check-ups are set with the diabetic in the two-week rhythm. Because diabetics more frequently suffer from illnesses like sheath infections, urinary tract infections and gestosis. A fine-meshed control therefore ensures an optimal supply of mother and child.

Among other things the following special diagnostic measures are recommended to diabetics:
  • Dopplersonography
  • Urinalysis every two weeks,
  • On the blood-sugar level HbA1c test allows examination possibility, the conclusions (every four weeks. The so-called blood sugar memory is found out. From a blood sample you determine as sugar hemoglobin is availably much HbA1c which means how much blood pigment (hemoglobin) is connected to sugar (glycosiert). This value shows the height of the average blood sugar values during the last six to twelve weeks).
  • Eyeground endoscopy every three months,
  • Alpha fetoprotein test (AFP) in the 16th pregnancy week,
  • Control of insulin and C-peptide from the fetus water,
  • Test of Estriol (E3.) (Estriol is a female hormone. Normal blood levels of this hormone indicate that the child is healthy).
Pregnancy diabetes

A till now latent one (without symptoms going) diabetes can make troubles due to the changed hormone lie in the pregnancy now. An existing diabetes can as well deteriorate pregnancy conditionally. References to the diabetic metabolism readiness arise from the anamnesis which is documented in the mother passport. Risk factors are: familial diabetic predisposition, am missing or gone ahead stillbirths, birth of an overweight and/or malformed child.

Broader symptoms of a latent diabetes can be: amplified thirst feeling, strong overweight of the nascent mother, permanent tiredness, oversized fetus and too much fetus water. The attending doctor discovers sugar he will arrange for secondary tests (glucose tolerance test test, test of the sober blood sugar value) in the urine. If the diagnosis pregnancy diabetes is safeguarded, the nascent mother must surround its nutrition and observe a special diet. This doesn't lead to the success, must be given therapy to with insulin so. The control is then carried out as in the case of a woman with an obvious diabetes. After the birth the blood sugar values usually of the mother bring themselves back to normal again.


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