Pregnant women with diabetes are more likely to have complications during pregnancy than women who aren't diabetic. Diabetes in pregnancy can be caused by the pregnancy (also known as gestational diabetes) or can be Type I (insulin dependent) or Type II (adult onset). Women with preexisting diabetes are more likely to have complications in pregnancy than gestational diabetics.
Pregnancy-Induced Hypertension
Pre-eclampsia, also known as pregnancy-induced hypertension (PIH), is a rise in maternal blood pressure accompanied by fluid retention, swelling and protein in the urine. Diabetics are more likely to be diagnosed with PIH, which can lead to seizures and death, says the University of Virginia Health Center. PIH can also cause growth retardation in the fetus, stillbirth or placental abruption. Abruption causes severe bleeding and risk of death to the mother and fetus. Hemolysis elevated liver enzymes low platelets (HELLP syndrome) causes red blood cells to be destroyed, which cause clotting to fail. Liver damage is also present. HELLP syndrome is a life-threatening complication of pregnancy.
Women with diabetes should be under the care of a high-risk obstetrician who monitors the patient frequently.
Worsening Retinopathy or Nephropathy
Diabetics may have damaged kidneys or retinas from damage to small blood vessels. This can worsen during pregnancy, according to E. Albert Reece, M.D., of the University of Maryland. Diabetic retinopathy can lead to blindness, and kidney damage can lead to the need for dialysis and, ultimately, kidney transplant. Keeping blood sugar under tight control helps decrease damage to the kidneys and retinas during pregnancy.
Fetal Effects
Maternal diabetes can greatly affect a fetus. Diabetic mothers have a higher incidence of miscarriage, stillbirth and birth defects, especially if they have preexisting diabetes rather than gestational diabetes. Babies born to diabetic mothers are more likely to be macrosomic, or large for gestational age, and are prone to respiratory distress because their lungs mature more slowly than normal. Newborns may also develop high bilirubin, or jaundice after delivery, which can cause brain damage if not properly treated, as well as hypoglycemia, which occurs as a result of the abrupt drop in blood glucose after delivery. The best way to prevent fetal complications is to keep maternal blood sugar under control during pregnancy.
Delivery Complications
Macrosomic babies are difficult to deliver due to their size and the fact that their shoulders have a larger circumference than their heads, which results in the shoulders getting stuck after the head is delivered, also known as shoulder dystocia. Diabetic mothers are more likely to need a cesarean section due to the baby's size. High-risk obstetric care during pregnancy ensures proper management of macrosomia and that delivery options will be carefully considered.
