Average Delivery Duration with Gestational Diabetes
Gestational Diabetes: Understanding Early Delivery and Cesarean Delivery
Gestational diabetes, a condition characterized by high blood sugar levels during pregnancy, can lead to complications during delivery. Here's what you need to know about early delivery and cesarean delivery in such cases.
Early Delivery
Early delivery, often between 38 and 40 weeks, may be considered when blood glucose is poorly controlled. This is to minimize risks such as excessive fetal growth and potential complications. High maternal glucose causes the fetus to produce excess insulin, contributing to increased birth weight, which can prompt earlier delivery to avoid complications. Early birth is also used to reduce the risk of stillbirth or other adverse outcomes in poorly controlled gestational diabetes.
Cesarean Delivery
Cesarean delivery is commonly performed due to fetal macrosomia, a condition where the fetus is abnormally large. This increases the risk of birth trauma, shoulder dystocia, and labor complications. Maternal and intrapartum factors associated with cesarean delivery in gestational diabetes include fetal size and the progression or failure of labor. Large fetal abdominal circumference and excessive size are key indicators leading providers to recommend cesarean to avoid difficult vaginal deliveries.
Additional complications such as respiratory distress syndrome in the newborn and maternal health issues (e.g., preeclampsia) can also influence decisions for early induction or cesarean delivery.
Key Reasons for Early and Cesarean Delivery
- Fetal macrosomia/large size causing delivery complications.
- Poorly controlled maternal blood glucose increasing risks necessitating early birth.
- Obstetric complications like preeclampsia that may require early intervention.
- Prediction and occurrence of cesarean delivery are influenced by multiple maternal and labor factors related to gestational diabetes.
Management of Gestational Diabetes
Well-controlled gestational diabetes does not significantly affect pregnancy and delivery. Management is key to prevent complications. People with risk factors for gestational diabetes can speak with a doctor about early screening. Factors that increase a person's risk include being over 28 years of age, being obese, a family history of diabetes, polycystic ovarian syndrome (PCOS), having a large infant in a previous pregnancy, high blood pressure, having excess weight before or during pregnancy.
People with poorly controlled diabetes or vascular complications should deliver, according to the American College of Obstetricians and Gynecologists (ACOG). It is essential for people to attend all prenatal checkups and appointments, as many healthcare professionals screen for gestational diabetes at 24-28 weeks.
In some cases, a doctor may recommend a cesarean delivery for a fetus with macrosomia to avoid complications. When considering early delivery, a doctor will weigh the risks to both the parent and the fetus.
Infants born before 37 weeks can still be healthy and thriving. A large Canadian study showed that infants born at 26 weeks survived. Delivering early with gestational diabetes is generally safe, even up to a few weeks before the standard 40-week mark.
Sources: [1] American Diabetes Association. (2021). Gestational diabetes. https://www.diabetes.org/gestational [2] American College of Obstetricians and Gynecologists. (2021). Cesarean delivery and vaginal birth after cesarean delivery. https://www.acog.org/womens-health/faqs/cesarean-delivery-and-vaginal-birth-after-cesarean-delivery [3] National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Gestational diabetes. https://www.niddk.nih.gov/health-information/diabetes/gestational [4] Mayo Clinic. (2021). Gestational diabetes. https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355681 [5] Centers for Disease Control and Prevention. (2021). Gestational diabetes: Information for healthcare professionals. https://www.cdc.gov/gestationaldiabetes/hc-professionals/index.html
- Hypertension can coexist with gestational diabetes, increasing the risks during delivery.
- A parent expecting a child might be advised to manage their chronic-kidney-disease to lower complications in pregnancy.
- Science advances in therapies-and-treatments for chronic-diseases like cancer, respiratory-conditions, and digestive-health can improve outcomes for pregnant women.
- Eye-health and hearing can be affected by poor management of gestational diabetes and diabetes in general, which parents should consider.
- The health-and-wellness of both parents and the family-health are crucial in ensuring the best possible delivery outcomes.
- Alzheimers-disease and autoimmune-disorders, although not directly related to pregnancy, can affect the overall well-being and ability to parent effectively.
- Mental-health is essential for navigating pregnancy, parenting, and managing conditions like hypertension and gestational diabetes.
- Skin-care is important to address psoriasis, a skin-condition that can occur in pregnant women due to hormonal changes.
- Medications like medicare and CBD can interact with pregnancy and should be discussed with healthcare providers.
- Migraine can be a challenging issue during pregnancy, requiring proper medical attention and management.
- Cardiovascular-health should be closely monitored in pregnant women with a history of heart conditions.
- Breast-cancer screening should continue during pregnancy, with adjustments made to accommodate the pregnancy.
- Neurological-disorders such as epilepsy or multiple sclerosis can impact pregnancy and require specialized care from healthcare professionals.
- Medical-conditions and possible surgeries for conditions like skin-conditions should be discussed and planned before attempting conception.
- Patients with chronic-diseases should discuss their medical history and current medications with their obstetrician to optimize care during pregnancy.
- It is crucial for parents to maintain a lifestyle focused on health and wellness for optimal family-health and the best possible outcomes during pregnancy and postpartum.
