When diabetes starts during pregnancy, it is called gestational diabetes. Women with diabetes (whether or not it is classified as gestational diabetes) need special care during pregnancy.
Diabetes is a condition that prevents the body from using food properly. The body receives its major source of energy from a sugar known as glucose. Insulin, a hormone manufactured in the pancreas, must be available for glucose to be used in the tissues. During pregnancy, some of the hormones produced by the placenta have a blocking effect on insulin. Gestational diabetes occurs when the pancreas produces its maximum amount of insulin, yet that is not enough to overcome the effect of the placenta’s hormones.
What are the risk factors for gestational diabetes?
Gestational diabetes is more common in women who
- are overweight or obese
- are older than 25
- have had gestational diabetes in a prior pregnancy
- are African American, American Indian, Asian American, Hispanic, Latina or Pacific Islander
- have a family history of diabetes
- have previously given birth to an infant that weighed more than 10 pounds
- had excess amniotic fluid in a prior pregnancy
- had an unexplained stillbirth or miscarriage in a prior pregnancy
How is gestational diabetes diagnosed?
At Virginia Women’s Center, we screen for gestational diabetes at 28 weeks of pregnancy. You will have to drink a syrupy glucose solution and then have your blood sugar level measured one hour later. If your blood sugar level is higher than normal, you will have to do a follow-up glucose test. The follow-up test involves drinking another glucose solution and having your blood sugar level checked every hour for a three hour period. If at least two of the blood sugar readings are higher than normal, you will be diagnosed with gestational diabetes.
What if I am diagnosed with gestational diabetes?
If you are diagnosed with gestational diabetes, you will work closely with our nurse practitioners to create an individualized food plan. You will not have to give up foods you love, but you may have to limit them or eat them with other foods so that your blood sugar isn’t negatively affected. During pregnancy, you will have to manage your blood sugar so that it stays in the optimal range and reduces your risk for complications. Usually, this can be done through diet and exercise. You will also work closely with our physicians and may need additional testing to monitor the baby’s health and reduce the risk of complications throughout your pregnancy.
For most women, once the baby is delivered, gestational diabetes will go away. You will be tested again at your postpartum visit. If it does not go away, it is reclassified almost always as type II diabetes. Women who had gestational diabetes are at high risk of having diabetes later in life. Choosing to pursue a healthy lifestyle by eating nutritiously and exercising regularly may help prevent or postpone diabetes.
Additional Resources:
Virginia Women’s Center is an advertiser on Richmondmom.com
]]>
While the exact cause of preterm labor is often unknown, there are some risk factors that increase a woman’s chance of having preterm labor. However, it is important to remember that preterm labor can happen to anyone and many women who experience a premature birth have no known risk factors. Some of the risk factors include:
- Preterm labor or preterm birth in a previous pregnancy
- Being pregnant with multiples (twins, triplets or more)
- Certain problems with your uterus, cervix or placenta
- Having little or no prenatal care
- Smoking or drug use
- Abdominal surgery during this pregnancy
- Too much amniotic fluid
- Bleeding or infection while pregnant
- Being underweight or overweight
A preterm labor typically begins unexpectedly. The signs of preterm labor are often no different from regular labor, except that they happen before the 37th week of pregnancy. If you experience any of the warning signs listed below before your 37th week of pregnancy, call your doctor. Sometimes, preterm labor can be stopped. However, there are certain situations and complications that make an earlier delivery safer for the mother or baby. The warning signs for preterm labor include:
- Contractions, where your abdomen tightens like a fist, every 10 minutes or more often
- Change in vaginal discharge, such as a watery, mucus-like fluid leaking from the vagina, or bleeding
- Pelvic pressure; the feeling that your baby is pushing down
- Low, dull backache
- Cramps that feel like your period
- Abdominal cramps with or without diarrhea
Women who are at risk for preterm labor may be advised to take certain steps to prevent preterm birth. At Virginia Women’s Center, we have three maternal-fetal medicine specialists who collaborate with our OB-GYNs in the care of high-risk pregnancies. Read this blog post to learn more about our maternal-fetal medicine specialists and the care they provide to women who are experiencing high-risk pregnancies.
Virginia Women’s Center is an advertiser on Richmondmom.com
]]>
Genetics is the branch of science that deals with how traits are passed from parent to child through genes. Genetic counselors have an advanced degree in the field of genetics.
Laurie Tams, the genetic counselor at Virginia Women’s Center, works with mothers and couples to explain the array of prenatal testing options available and helps to interpret the test results. She works closely with the maternal-fetal medicine specialists and obstetricians.
If you and your partner are considering pregnancy or are newly pregnant, you might be amazed and/or overwhelmed with the number of prenatal testing options available. There are three different types of genetic testing that are offered during pregnancy.
- Carrier testing of both parents will detect if either parent is a carrier of a certain genetic defect. A carrier test can be done before, during or after pregnancy and is performed by obtaining a blood sample which is then studied in a lab to detect a defective gene for a certain inherited disorder.
- Screening tests are available to detect some birth defects during pregnancy. However, a screening test only shows if there is an increased risk that a defect will occur.
- If a screening test or other factors raise concerns, diagnostic tests often can show whether certain birth defects are present.
For more detailed information on some of the carrier and screening tests available, check out the Focus on Health videos that are available on the Virginia Women’s Health website.
Reasons for Referral to a Genetic Counselor
Your obstetrician may refer you to Laurie Tams or another genetic counselor for one or more of the following reasons:
- You are planning to start a family and either you, your partner or a close relative has an inherited illness.
- You already have one child with a severe birth defect.
- You have had two or more miscarriages.
- You have delivered a stillborn child with physical signs of a genetic illness.
- You are pregnant and over age 34.
Genetic testing offers greater ability to diagnose and address birth defects during pregnancy. However, whether you want to be tested to see if your baby is at increased risk for birth defects or genetic disorders is a personal choice.
Some couples choose not to be tested for birth defects. Others find that testing and counseling can help them better plan for the future. Working with a genetic counselor can be reassuring and informative, especially if you or your partner has a known risk factor.
It’s important to keep in mind that the genetics field is expanding exponentially, so new developments—often complex—can come to light every day.
For more information, contact the Virginia Women’s Center.
Virginia Women’s Center is an advertiser on Richmondmom.com
A high-risk or difficult pregnancy might pose challenges before, during or after delivery. We’ve seen the discussions in our Richmondmom.com Junkies Facebook group and understand the challenges this brings for expectant families.
If you are at risk, you and your baby might need special monitoring or care throughout your pregnancy. VCU Medical Center and Children’s Hospital of Richmond at VCU (CHoR) will host a panel of experts in neonatal and maternal-fetal medicine as they discuss the causes of high-risk pregnancies, and what you can do to take care of yourself
and your baby.
Details:
- Drs. Karen Hendricks-Muñoz, Elena Kwon and Ronald Ramus
- Wednesday, Oct. 24, from 5:30 to 6:30 p.m.
- Lewis Ginter Botanical Garden, 1800 Lakeside Ave.
- Free and open to the public, but registration is recommended. For more information, visit VCUHealth.org. To register, call 828-0123.
About the Presenters
Dr. Karen Hendricks-Muñoz, professor and chief of the Division of Neonatal Medicine, serves as director of Children’s Hospital of Richmond at VCU’s Neonatal Intensive Care Unit (NICU).
Board certified in pediatrics and neonatal medicine, Hendricks-Muñoz specializes in neonatal intensive care, pulmonary disease and neurodevelopmental outcomes. She is a member of the American Academy of Pediatrics, American Academy of Developmental Pediatricians and the Eastern Society of Pediatric Research.
Dr. Elena Kwon, a board certified pediatric cardiologist with advanced imaging fellowship training, specializes in fetal cardiology, echocardiography and cardiac magnetic resonance imaging (MRI). Kwon leads Children’s Hospital of Richmond at VCU’s Fetal Cardiology Program.
The program works closely with cardiologists and surgeons, as well as obstetricians and maternal-fetal specialists, to help provide the best possible outcomes for newborns with cardiac defects.
Dr. Ronald Ramus, chief of maternal-fetal medicine at VCU, brings expertise in many prenatal diagnostic
techniques, including chorionic villous sampling.
Chorionic villous sampling is a way to diagnose chromosomal or genetic disorders in the first trimester, earlier than amniocentesis screening can be done.
Children’s Hospital at VCU is an advertiser of Richmondmom.com.
]]>