By week 37 of pregnancy, a woman has likely been managing her gestational diabetes for about nine weeks. Blood tests for the condition are performed at the beginning of the third trimester, around 28 weeks. Although gestational diabetes does place women in a higher pregnancy risk category, the condition can be managed with careful vigilance. The American Congress of Obstetricians and Gynecologists says that between two and 10 percent of women are diagnosed with gestational diabetes annually.
Gestational Diabetes Defined
The ACOG defines gestational diabetes as excess levels of glucose in the blood. Excess glucose occurs when the body does not produce enough insulin to convert glucose into energy. The condition comes and goes with pregnancy. Women who develop gestational diabetes with one pregnancy are more likely to develop it in subsequent pregnancies. The ACOG says that up to one half of them will develop type 2 diabetes later in life.
Diet, exercise and, occasionally, medication are key to gestational diabetes control. Patients need to avoid refined carbohydrates, sugar and caffeine and maintain a regimen of either swimming, walking or prenatal yoga. Insulin shots are sometimes necessary.
If gestational diabetes is not controlled, serious complications may occur. They include premature birth; preeclampsia, or abnormally high maternal blood pressure; respiratory distress syndrome, or difficulties with baby’s breathing at birth; birth defects; and macrosomia, or an extremely large baby. According to Midwifery Today, the baby can go into diabetic shock and die during birth in cases of improper disease management.
By 37 weeks, women with gestational diabetes will be checked weekly. Because of the risks of preeclampsia and macrosomia, these women have a slightly higher chance of delivering their babies via cesarean section. Doctors will monitor the size of the baby, maternal glucose levels and blood pressure closely to determine whether a cesarean is necessary. Pregnancies are term between 37 and 42 weeks, so babies would likely be born without complication at this time.
All pregnant women need to monitor fetal kick counts for their doctors or midwives by week 37 of pregnancy. Women with gestational diabetes are no exception. If the number of fetal movements in any two-hour span drops below 10, they should contact their doctor or midwife immediately. This is an indication of severe fetal distress.