Conditions such as diabetes, thyroid disease, and blood clotting disorders (known as thrombophilias) are of special concern while you are pregnant because of the risk they pose to you and your baby. While most women with these types of conditions have uneventful pregnancies and healthy babies, they do require special monitoring and, in some cases, treatment during pregnancy.
Diabetes During PregnancyConditions such as diabetes, thyroid disease, and blood clotting disorders (known as thrombophilias) are of special concern while you are pregnant because of the risk they pose to you and your baby. While most women with these types of conditions have uneventful pregnancies and healthy babies, they do require special monitoring and, in some cases,treatment during pregnancy: Diabetes During Pregnancy If you are diabetic and become pregnant, your health and that of your baby can be at risk. The risk of having problems during your pregnancy is greatest when your blood sugar levels are too high. By controlling your blood sugar levels during your pregnancy, you can reduce the risk of: • Macrosomia occurs when your blood sugar level is high throughout pregnancy. This allows too much sugar to go to your baby and can cause the baby to grow too large, making delivery difficult. • Preeclampsia is high blood pressure during pregnancy. This can pose severe health problems for you and your baby and may require your baby to be delivered early. • Polyhydramnios occurs when there is too much amniotic fluid in the sac that surrounds the baby. This can result in preterm labor and delivery. • Urinary tract infections can occur without symptoms. If the infection is not treated, it may spread from the bladder to your kidneys. • Respiratory distress syndrome can make it harder for your baby to breathe after birth. • Stillbirth delivery of a baby that has died before birth - occurs more often in babies of women whose diabetes was not well controlled during pregnancy. By carefully monitoring blood sugar during pregnancy, most women who have diabetes can have healthy babies. Your doctor will closely monitor you during your pregnancy. Regular screening tests will be used to ensure early detection of any problems you or your baby may be having. You can also take the following steps to manage your diabetes during your pregnancy: • Eat a balanced diet consisting of several small meals and snacks throughout the day. • See your doctor regularly for checkups and tests. • Follow a moderate exercise program as prescribed by your doctor. • Check your glucose often each day to keep it at a normal level. • Take insulin injections or pills as prescribed by your doctor. By working together, you and your doctor can control your glucose level to help ensure you have a safe pregnancy and a healthy baby. In most cases, women with diabetes go into labor normally when the time comes and have a normal vaginal delivery. They may require special monitoring of their glucose levels and the baby during labor. If there are problems during pregnancy, labor may need to be induced early. After birth, most babies do well. Some babies may need to spend time in a special care nursery. Problems that may occur include: • Low glucose levels • Low blood calcium and magnesium levels • An excess of red blood cells • Neonatal jaundice (yellow discoloration of the skin) • Breathing problems. These problems are not serious in most cases and are all treated fairly easily soon after birth. If your blood sugar levels are well controlled during pregnancy, your baby is less likely to have problems after birth. Women with diabetes can breastfeed their babies in most cases.
Thyroid Disease During PregnancyThyroid disease can pose a risk to you and your baby during pregnancy. However, with close monitoring and proper medical treatment, you can reduce these risks and have a healthy baby. Throughout your pregnancy, your doctor will regularly check the levels of thyroid hormone in your body to be sure they are at healthy levels. Though many of the medications used to treat thyroid disease are safe for your unborn child, your doctor will also closely monitor your baby throughout your pregnancy. If you have a history or symptoms of thyroid disease and are thinking of becoming pregnant or are pregnant already, it is important to talk to your doctor. Risks of Hypothyroidism For Your Baby: • Smaller than normal birth weight • Preterm birth (born before 37 weeks of pregnancy) • Decreased mental ability For You: • Preeclampsia • Placental abruption The chance of problems during pregnancy is greatest when thyroid disease is not monitored, treated, and controlled. Risks of Hyperthyroidism For Your Baby: • Smaller than normal birth weight • Preterm birth • Possible death • Hyperthyroidism For You: • An irregular heartbeat or heart failure • Thyroid storm
Thrombophilias During PregnancyThrombophilias refers to a group of disorders that promote blood clotting. If you have one of these disorders, your body tends to form blood clots too easily. While as many as one in five people in the United States has a thrombophilias, most people do not know they have one of these disorders because they produce no symptoms. Pregnancy is a time when signs of thrombophilia are more common. Most women with a thrombophilia have healthy pregnancies; however, this condition can contribute to a number of pregnancy complications: • Fetal loss / Miscarriage • Poor fetal growth • Placental abruption • Preeclampsia • Venous thromboembolism or VTE. Most of the problems that occur during pregnancy are believed to result from blood clots in placental blood vessels that lead to placental changes and reduced blood flow to the baby. If you become pregnant and have had any type of blood clot, your doctor will recommend screening blood tests for thrombophilia. Your doctor may also recommend a screening test if: The risk of blood clots or pregnancy complications due to thrombophilia appears to be less than 1 percent in women with no history or family history of blood clots. • You have a family history of blood clots, pulmonary embolism, or strokes that occurred before age 60. • You have a history of pregnancy complications (i.e. several miscarriages). If you test positive for thrombophilia and your doctor believes your risk of blood clots and pregnancy complications is strong enough, you may be treated with a blood-thinning drug called heparin. This drug is given by injection daily and is safe for your baby because it does not cross the placenta. However, most women with a thrombophilia disorder need only to be monitored closely throughout pregnancy.