Gestational Diabetes and Cesarean Delivery
Gestational diabetes carries an increased risk to several complications with the birth of a child as well as some long term neurological problems that can plague the child through their young years.
Women who are a greater risk of gestational diabetes are those who had the condition with a previous pregnancy, had a previous stillbirth, family history of diabetes or are obese. Each of those factors can lead to a birth that ends in a cesarean delivery.
Gestational diabetes and cesarean delivery may be an option that is chosen for several different reasons. Gestational diabetes is a metabolic disorder that has minimal signs and symptoms. It used to be that many women weren’t diagnosed with gestational diabetes until their baby was born macrosomic. In other words, the baby was over 9 pounds large which is one of the problems that babies experience when they are exposed to large amounts of simple sugars through the placenta.
When babies are over 8 pounds in weight at birth it becomes very difficult and even dangerous for the baby to be born vaginally. Complications can include neurological injury or physical injury to the baby as he travels through a canal not large enough to carry him. Babies who are too large at birth also have difficulties with breathing after their birth.
A cesarean delivery is a bit of a catch-22 situation because during the birth process the lungs are cleared by the squeezing process but because of the size of the baby neurological or physical injury can occur.
In a research study published in Diabetes Care in 2000 researchers from New South Wales, Australia found that the rate of cesarean sections in women with gestational diabetes wasnt higher than those who had normal blood sugars through their pregnancy. In each case cesarean sections accounted for between 15 and 17%.
These findings point to the more positive factor that gestational diabetes is being detected, diagnosed and treated in the earlier stages so that babies aren’t suffering from some of the complications of large amounts of blood sugar through the last two trimesters of development.
The signs and symptoms of gestational diabetes are often obscured by the signs and symptoms of pregnancy. Because of the complications from gestational diabetes and cesarean delivery women often undergo a simple blood test between 24 and 28 weeks gestation to determine if their blood sugar results are too high indicating they have gestational diabetes. This early detection and treatment has become the standard of care in most industrialized nations around the world.
Researchers have also found that there are more long term neurological effects to babies exposed to high amounts of sugar or ketones through development. Although, to date, research has shown that these neurological deficits resolve slightly there is still a link between gestational diabetes and lower verbal IQ scores and inattention and hyperactivity in children.
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