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Pregnant women diagnosed with gestational diabetes have a higher risk of suffering a premature birth, inducing labor and even losing the baby due to their excessive growth. However, these risks can be reduced by keeping the blood sugar level properly controlled throughout pregnancy.
Pregnant women who keep their blood glucose under control and who do not have babies weighing more than 4 kg can wait until 38 weeks of gestation for spontaneous labor to begin, and can have a normal delivery, if this is their wish. However, if it is proven that the baby has more than 4 kg, the doctor may suggest a cesarean section or induction of delivery at 38 weeks.
Gestational diabetes is characterized by an intolerance to carbohydrates that occurs, for the first time, during pregnancy, and there are more associated risks if it occurs during the first trimester of pregnancy.
Risks for the mother
The risks of childbirth in gestational diabetes, which can occur in pregnant women, can be:
- Prolonged normal delivery due to poor uterine contractility;
- Need to induce labor with medications to initiate or accelerate normal delivery;
- Laceration of the perineum during normal delivery, due to the size of the baby;
- Urinary tract infection and pyelonephritis;
- Eclampsia;
- Increased amniotic fluid;
- Hypertensive disorders;
In addition, after delivery, the mother may also experience a delay in starting breastfeeding. Learn how to solve the most common breastfeeding problems.
Risks for the baby
Gestational diabetes can present risks to the baby during pregnancy or even after delivery, such as:
- Birth before the due date, due to the rupture of the amniotic sac before 38 weeks of gestation;
- Decreased oxygenation during delivery;
- Hypoglycemia after birth;
- Abortion at any time of pregnancy or death shortly after delivery;
- Hyperbilirubinemia;
- Birth weighing more than 4 kg, which increases the risk of developing diabetes in the future and of suffering some change in the shoulder or fracture of the clavicle during normal delivery;
In addition, children may suffer from obesity, diabetes and cardiovascular disease in adulthood.
How to decrease the risk
To reduce the risks of gestational diabetes, it is important to keep blood glucose under control, checking capillary blood glucose daily, eating properly and exercising, such as walking, water aerobics or weight training, about 3 times a week.
Some pregnant women may need to use insulin when diet and exercise are not enough to control blood sugar. The obstetrician, in conjunction with an endocrinologist, can prescribe daily injections.
Learn more about the treatment of gestational diabetes.
Watch the following video and learn how eating can reduce the risks of gestational diabetes:
How is postpartum gestational diabetes
Right after delivery, blood glucose should be measured every 2 to 4 hours, in order to prevent hypoglycemia and ketoacidosis, which are common in this period. Normally, glycemia normalizes in the postpartum period, however, there is a risk that the pregnant woman will develop type 2 diabetes in about 10 years, if she does not adopt a healthy lifestyle.
Before hospital discharge, the mother's blood glucose should be measured in order to verify that it is already normalized. Generally, oral antidiabetics are discontinued, but some women need to continue taking these medications after delivery, after an evaluation by the doctor, so as not to harm breastfeeding.
The glucose intolerance test should be performed 6 to 8 weeks after delivery, to verify that blood glucose remains normal. Breastfeeding should be encouraged because it is essential for the baby and because it helps with postpartum weight loss, insulin regulation and the disappearance of gestational diabetes.
If blood glucose remains controlled after delivery, the healing of cesarean section and episiotomy occurs in the same way as in women who do not have gestational diabetes, however, if the values do not return to normal, healing may take longer.