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Antenatal Care

Gestational Diabetes

Antenatal Care
Southside ob-gyn

Gestational Diabetes Mellitus (GDM) is a condition affecting blood sugar levels causing them to be elevated. It occurs in women during pregnancy, most commonly in the second trimester. These patients would have had normal blood sugar levels prior to the pregnancy.

  • 12.4% of women in Brisbane are affected by GDM (higher risk in certain ethnicities).
  • Women with GDM have a 7 times greater risk of developing type 2 diabetes in later life than women without GDM.
  • An approximate 30% risk of a recurrence of their GDM in a subsequent pregnancy and up to 50% risk of developing Type 2 Diabetes within 10-20 years.
  • Children born to mothers with GDM are at greater risk of obesity, metabolic syndrome, future GDM and type 2 diabetes than those born to unaffected mothers.

The recommendation is for universal screening in the form of a blood test called a Glucose Tolerance Test. This is performed routinely between 26 and 28 weeks gestation. Some patients may be screened in early pregnancy if they have risk factors for Pre-existing Diabetes, such as obesity, a history of a previous pregnancy with GDM, or a family history of Diabetes.Complications of GDM:

  • Large babies or what is referred to as Macrosomia which leads to:
    • Increased risk of operative delivery: Caesarean and Instrumental such as forceps or suction vacuum.
    • Shoulder dystocia: When the baby’s shoulders fail to deliver after the baby’s head. This is an emergency and can lead to further complications such as fractured baby bones and nerve damage.
  • Preeclampsia: A disease occurring in pregnancy that leads to high blood pressure and can affect multiple organs in the mother. If untreated, it can lead to maternal seizures referred to as eclampsia.
  • Intrauterine Fetal Demise: If the GDM is poorly controlled, it can lead to fetal death.

Treatment of GDM is based on improving the diet and exercising. This may be sufficient to control the blood sugar levels. If conservative measures fail to control blood sugar levels, the doctors will prescribe either tablets or insulin injections to control your sugar levels. The pregnancy is deemed a high-risk pregnancy, especially if the patient is medicated and/or there is evidence of macrosomia or preeclampsia. Pregnancies affected by GDM may require either an early induction of labour or a Caesarean Section if the baby’s estimated weight on ultrasound scan is equal or more than 4.5 kg.