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You will be subject to the destination website's privacy policy when you follow the link. CDC is not responsible for Section compliance accessibility on other federal or private website. An ultrasound uses sound waves and a computer screen to show a picture of your baby in the womb. Your provider also may ask you to do kick counts also called fetal movement counts. This is way for you to keep track of how often your baby moves in the womb.
Here are two ways to do kick counts:. If you have GDM, your provider tells you how often to check your blood sugar, what your levels should be and how to manage them during pregnancy. Blood sugar is affected by pregnancy, what you eat and drink, how much physical activity you get. You may need to eat differently and be more active. You also may need to take insulin shots or other medicines.
Treatment for GDM can help reduce your risk for pregnancy complications. Your provider begins treatment with monitoring your blood sugar levels, healthy eating and physical activity. Insulin is the most common medicine for GDM.
For most women, gestational diabetes goes away after giving birth. But having it makes you more likely to develop type 2 diabetes later in life. Type 2 diabetes is the most common kind of diabetes. Get expert tips and resources from March of Dimes and CDC to increase your chance of having a healthy, fully-term pregnancy and baby.
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Rebecca Dekker. PhD, RN. Get our free, one-page handout on Induction for GDM today to use in your informed decision making! What is gestational diabetes? What problems can result from gestational diabetes?
Does gestational diabetes always mean induction of labor? Evidence from randomized controlled trials Biesty et al. Evidence from observational studies Given that there is only one randomized, controlled trial on this topic, it is important to look at observational studies on this topic.
Table 1: Observational studies of early induction vs. Maternal Outcomes with Elective Induction vs. Expectant Management The largest study to look at maternal outcomes included over 8, pregnant people with GDM.
Why might Cesareans go up after 40 weeks? Newborn Outcomes with Elective Induction vs. Expectant Management The largest observational study on GDM and induction found that newborns of mothers who are induced during their 38 th week of pregnancy tend to have more health problems than newborns of mothers who are induced during their 39 th week of pregnancy. Stillbirth One study focused on the risk of stillbirth and infant death for people with GDM who give birth at different gestational ages Rosenstein et al.
Other Research on Induction for Gestational Diabetes We wanted to briefly mention two other studies that have been published since Are there effective treatments for gestational diabetes that reduce the risk of poor outcomes? Overview of Cochrane systematic reviews on treatments for gestational diabetes Several Cochrane reviews have looked at different treatments to improve pregnancy outcomes for people with GDM.
Systematic review and meta-analysis by Farrar et al. Treatment for gestational diabetes improves outcomes The good news is that treatment for gestational diabetes improves outcomes. Recently updated practice guidelines on labor induction with gestational diabetes The American College of Obstetricians and Gynecologists ACOG advises against inducing labor before 39 weeks in people with GDM who have well-controlled blood sugar levels with diet and exercise alone.
Conclusion At this time, there is no evidence from randomized controlled trials to support routinely inducing labor at 38 or 39 weeks for everyone with GDM. The one randomized trial on induction for gestational diabetes failed to find any benefits for the mother or baby from elective induction between 38 weeks, 0 days and 39 weeks, 0 days of pregnancy versus waiting for labor to start on its own until 41 weeks, 0 days, as long as no medical problems developed.
Importantly, this trial was not large enough to detect a difference in stillbirth. There is some evidence from observational studies that people with GDM who give birth at 39 or 40 weeks have a lower relative risk of perinatal death compared to those who continue the pregnancy beyond 40 weeks. However, the absolute risk of perinatal death is low whether a mother chooses planned early birth or waits for labor to start on its own.
At 40 weeks, the absolute risk of stillbirth or newborn death was 10 deaths per 10, for people who gave birth versus 17 deaths per 10, with expectant management for one more week. It is possible that these potential benefits of early induction do not apply to mothers with GDM who have well-managed blood sugars.
References: Alberico, S. Immediate delivery or expectant management in gestational diabetes at term: the ginexmal randomised controlled trial. BJOG: an international journal of obstetrics and gynaecology ; 4 — American College of Obstetricians and Gynecologists Fetal macrosomia. Practice Bulletin No. Obstet Gynecol ;e— American Diabetes Association Arshad, R. Effects of insulin on placental, fetal and maternal outcomes in gestational diabetes mellitus.
Pak J Med Sci;30 2 Bas-Lando, M. Elective induction of labor in women with gestational diabetes mellitus: an intervention that modifies the risk of cesarean section.
Arch Gynecol Obstet; 5 Berger, H. Diabetes in Pregnancy. JOGC; 38 7 Biesty, L. Planned birth at or near term for improving health outcomes for pregnant women with gestational diabetes and their infants.
Cochrane Database of Systematic Reviews , Issue 1. Ginekol Pol; 88 4 Brown, J. Lifestyle interventions for the treatment of women with gestational diabetes. The fetus converts the extra glucose to fat. Even when the mother has gestational diabetes, the fetus is able to produce all the insulin it needs. The combination of high blood glucose levels from the mother and high insulin levels in the fetus results in large deposits of fat which causes the fetus to grow excessively large.
Hypoglycemia refers to low blood sugar in the baby immediately after delivery. This problem occurs if the mother's blood sugar levels have been consistently high, causing the fetus to have a high level of insulin in its circulation. After delivery, the baby continues to have a high insulin level, but it no longer has the high level of sugar from its mother, resulting in the newborn's blood sugar level becoming very low.
The baby's blood sugar level is checked after birth, and if the level is too low, it may be necessary to give the baby glucose intravenously. Blood glucose is monitored very closely during labor. Insulin may be given to keep the mother's blood sugar in a normal range to prevent the baby's blood sugar from dropping excessively after delivery. Health Home Conditions and Diseases Diabetes. What causes gestational diabetes mellitus?
Although the cause of GDM is not known, there are some theories as to why the condition occurs.
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