Gestational diabetes

Pregnancy sugar, gestational diabetes, pregnancy diabetes, or diabetes during pregnancy are different names for one and the same disease: gestational diabetes.

Any disturbance of glucose metabolism during pregnancy approved is known as gestational diabetes, regardless of whether the diabetes newly occurred during pregnancy or was already previously undetected. Clearly it delineated is manifest before the pregnancy diabetes already (= diabetes in Graviditate). Here it's usually a type I diabetes.

Causes of gestational diabetes

About 2.5 percent of all pregnant women are diabetic. The reason for the occurrence of the disorder is not entirely clear. Probably there is a genetic predisposition for the diabetic metabolic status. Females probably already have the potential for an increased blood sugar levels before pregnancy.

As a strong shift in hormonal balance takes place during pregnancy, it is assumed that there is interaction between the female sex hormones (estrogen, progesterone), placental hormones (HCG, HPL) and insulin is the blood sugar-regulating hormone. May hormones present in high concentration of stimulate the secretion of insulin, until the reserves are exhausted, or reducing the effect of the end organ (muscle, liver).

At the same time insulin is, mined so it is assumed in the placenta (placenta) increased, which further reduces the sugar recovery and promotes a high sugar content in the blood.

Symptoms and signs

The gestational diabetes as a result that the high sugar levels occur especially after the food intake is different from the "ordinary" diabetes. Also, an increased tendency to vomiting, making it difficult to control blood sugar levels through a targeted food supply is reflected in the first months of pregnancy.

For the pregnant women, diabetes means also increased susceptibility to urinary tract infections and increased risk of training a gestosis, a serious pregnancy complication. The formation of amniotic fluid by the fetus (polyhydramnios) often propagated in this context can cause tension pain in the abdomen, a feeding disorder and impaired breathing. Further, there is the danger that the metabolic derailment persists after childbirth.

For the unborn child, the consequences are usually more serious than for the mother. The negative effect of sugar on the vessels leads to a decreased blood flow to the placenta, which jeopardizes the nutrition of the fetus (placental insufficiency). This problem is exacerbated by the mechanical pressure, which can arise from the polyhydramnios.

Untreated diabetes pregnancy

Diabetes pregnancy if left untreated held, the newborn shows the typical characteristics of the so-called diabetic fetal often (in around 40 percent of cases). It is characterized by the contrast between an abnormally large child (4.5 kg and more) and a significant development is lagging behind. Especially the lungs is affected by the immaturity, which is why it can cause the respiratory distress syndrome.

During pregnancy the unborn child reacts to the sugar oversupply of mother with an increased insulin secretion, to keep the own blood sugar (insulin lowers the concentration of sugar in the blood). Another problem thus arises from the low blood sugar levels in the newborn shortly after childbirth. By the absence of the high maternal intake of sugar, the child in relation to the now limited sugar supply has a high insulin levels.

Check the placental circulation

In the Switzerland, blood sugar checks are routinely performed for all pregnant women. Suspected, in addition, the size and the condition of the fetus using ultrasound is measured in addition to the conventional diabetes diagnosis. Through these regular observations, the development and growth of the unborn child can be recognized in addition to anomalies.

The control of blood flow to the placenta is performed with a Doppler Sonography. The alpha fetoprotein (AFP) to the exclusion of abnormalities is also determined in the 16th week of pregnancy. Optimal therapy, the risk for mother and child can be reduced to a minimum. The complications can be avoided by careful monitoring and immediate action frequently during and after the birth. Fortunately, the disorder disappears after pregnancy in the majority of cases.

Complications

The main risk for the mother (and thus also for the child) is that it can be a massive cardiovascular derailment (gestosis, Pfropfgestose) with edema, renal dysfunction (urinary protein excretion) and high blood pressure. In this case, even a premature birth threatens especially if at the same time an infection is present. No time and proper treatment, life-threatening convulsion States (eclampsia) can occur.

Birth problems arise with the placenta not working and the oversize of the child. The fruit may be disturbed due to diabetes for the mother in early development. This can lead to the abort or permanent damage (two to three times more common than in non diabetic) embryo (Embryopathy). These concern particularly the lower limbs, heart, and kidneys.

After the birth of a problematic metabolism (lower sugar levels, impaired electrolyte and water balance, high bilirubin levels) and breathing problems can (on the, respiratory distress syndrome) threatening the life of the infant. About a third of affected children, the immature lung can perceive its function fully.

Preventive measures

The pregnant women can contribute significantly to her and the welfare of the child through regular measurement of blood sugar levels and disciplined adherence to the diet. Medical side is the early detection and treatment of diabetes of great importance.

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