Blood glucose control during pregnancy is an important aspect of obstetrical care. Elevated levels during pregnancy can lead to delivery-related complications as well as newborn death, stillbirth and low blood glucose levels. Gestational diabetes is a condition of maternal elevated blood glucose levels that begin during pregnancy. Patients who already have Type 1 or 2 diabetes also need to ensure tight glucose control. Prevention and early treatment of elevated blood glucose levels is a topic that should be discussed as part of a routine pregnancy visit with a health care provider.
Gestational Diabetes
According to the American Diabetes Association, approximately 4 percent of all pregnant women will be diagnosed with gestational diabetes during pregnancy. The etiology or cause of gestational diabetes is unclear, but it may be related to placental hormones that lead to insulin resistance. Insulin resistance leads to elevated blood glucose levels because the action of insulin in the patient is impaired. Blood glucose levels are checked in pregnant women between the 24th and 28th gestational week. According to MayoClinic.com, a glucose challenge test is performed in which a pregnant women drinks a high glucose-containing syrup and blood glucose levels are checked; a normal reading is less than 140 mg/dL. A diagnosis of gestational diabetes is made for blood glucose levels greater than 140 mg/dL.
Macrosomia
Macrosomia is a condition in which the fetus is too large. Macrosomia can be caused by elevated blood glucose levels during pregnancy. It can lead to a variety of health problems and delivery complications, including difficulties with vaginal delivery. Some deliveries result in a condition known as shoulder dystocia, in which the infant's shoulder becomes stuck behind the pubic bone of the mother. This can result in injury to the infant or further complications with the delivery, according to the website Shoulder Dystocia.
Blood Glucose Post-delivery
The newborn infant's blood glucose level will be checked immediately after birth. Some infants who were subjected to elevated blood glucose levels during pregnancy have higher circulating insulin levels and develop low blood glucose levels, according to the Cleveland Clinic. Low blood glucose levels in an infant can lead to bluish skin or cyanosis, breathing problems, decreased muscle tone, irritability, nausea/vomiting, poor feeding and seizures, according to MedLine Plus.
Maternal Treatments
Gestational diabetes can be managed with lifestyle changes including increasing exercise and monitoring dietary intake. Some pregnant women do require oral anti-hyperglycemic medication such as glyburide or insulin injections. Type 1 and Type 2 diabetics may require alterations to the patient's current medications. According to the American Diabetes Association, goal blood glucose levels are between 70 and 130 mg/dL and less than 180 mg/dL within 2 hours after eating. Tighter blood glucose control is preferred to reduce fetal and labor complications.
