Risks of childbirth in gestational diabetes

Pregnant women diagnosed with gestational diabetes are at a higher risk of experiencing 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 sugar under control and who do not have babies weighing more than 4 kg can wait until 38 weeks of gestation for the spontaneous onset of labor, being able to have a normal delivery, if this is their wish. However, if it is proven that the baby weighs more than 4 kg, the doctor may suggest a cesarean section or induction of labor at 38 weeks.

Gestational diabetes is characterized by carbohydrate intolerance 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 may occur in pregnant women, can be:

• Prolonged normal delivery due to poor uterine contractility;
• Need to induce labor with drugs 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 pose risks to the baby during pregnancy or even after delivery, such as:

• Birth before the expected date, due to the rupture of the amniotic sac before 38 weeks of gestation;
• Decreased oxygenation during childbirth;
• Hypoglycemia after birth;
• Miscarriage at any time during pregnancy or death shortly after delivery;
• Hyperbilirubinemia;
• Birth weighing more than 4 kg, which increases the risk of developing diabetes in the future and suffering a shoulder change or collarbone fracture during normal delivery;

In addition, children can suffer from obesity, diabetes and cardiovascular disease in adulthood.

how to reduce 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, may prescribe daily injections.

Learn more about treating gestational diabetes.

Watch the following video and learn how diet can reduce the risks of gestational diabetes:

What is the postpartum period of gestational diabetes like?

Immediately after delivery, blood glucose should be measured every 2 to 4 hours in order to prevent hypoglycemia and ketoacidosis, which are common during this period. Normally, blood glucose normalizes postpartum, 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 check if it is already normalized. Generally, oral antidiabetic drugs are discontinued, but some women need to continue taking these drugs after childbirth, after a doctor’s evaluation, so as not to impair 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 is kept under control after delivery, the healing of the cesarean and episiotomy occurs in the same way as in women who do not have gestational diabetes, however, if the values ​​do not normalize, healing may take longer.