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Gestational Diabetes 38 Weeks Pregnant

Randomized Controlled Trial Of Induction At 38weeks Versus 40weeks Gestation On Maternal And Infant Outcomes In Women With Insulin-controlled Gestational Diabetes.

Randomized Controlled Trial Of Induction At 38weeks Versus 40weeks Gestation On Maternal And Infant Outcomes In Women With Insulin-controlled Gestational Diabetes.

Department of Obstetrics and Gynecology, General Hospital of Klagenfurt, St. Veiterstrae47, 9020, Klagenfurt, Austria. [email protected] To compare the impact of induction of labor at 38weeks of gestation with the induction of labor at 40weeks of gestation in women with insulin-treated gestational diabetes on maternal and fetal outcome. In this study 100pregnant women with insulin-treated gestational diabetes were randomized to either induction of labor at 38(groupI) or 40weeks (groupII) to evaluate the rate of large for gestational age newborns, neonatal hypoglycemia, success rate of deliveries within 48h and cesarean section rate after induction in both groups. The difference of large for gestational age newborns was not significant between the two groups (6.8% vs. 12.8%, p= 0.49), 16(36.4%) newborns in groupI and 8(17.0%) newborns in groupII developed hypoglycemia <35 mg/dl (p= 0.04). The success rate for deliveries within 48h after induction of labor for groupsI andII was 77.3% and 92.3%, respectively (p= 0.25). The cesarean section rate after induction of labor was not significantly different between the two groups (24.1% vs. 18.7%, p= 0.49). In acohort of women with insulin-treated gestational diabetes, induction of labor at 38weeks did not significantly reduce the rate of large for gestational age newborns compared to induction at 40weeks but seems to increase the rate of neonatal hypoglycemia. Continue reading >>

Gestational Diabetes Birth Stories

Gestational Diabetes Birth Stories

After experiences of your labour and birth for those who had gestational diabetes Gestational diabetes occurs when your body can not cope with the extra demand for insulin during pregnancy and results in high blood sugar. When gestational diabetes is well managed you can reduce the risk of complications to mum and baby. Read our expert advice on what gestational diabetes is and how to manage it. I had gestational diabetes and had the best pregnancy and birth. I managed my sugar levels through diet and exercise it was easy to do and I felt great. By the end of pregnancy I gained only 8 kilos, which is now all gone since I continued my diet after I had my boy. I have always been on the smaller side so we little people can get diabetes too (it runs in my family). The birth was as easy as a birth can get my waters broke and 3 hours later my little man arrived naturally. He was 10 days early and he weighed a tiny 6lb 4oz., which was fantastic. Actually a lot of my friends have had gestational diabetes and said it was the best thing for them because it forced them to eat properly and exercise. If you get the right education and manage your diabetes properly then you will be fine. Good luck Mai Footless babyjumpsuits for regular sugar testing Bring in jumpsuits with no feet, and buy baby socks, that way you dont have to undress them every time they need to test babies blood sugars. It will make it so much easier on both of you Sarah I was on metformin and had regular scans tracking bubs growth. A week before due 1 had a one off high bp reading but that meant I spent the next week have daily appointments with gp or midwife or bloods or scans. I got a call 2 days before due date to go to hospital to be induced as blood flow to bub was reduced (gd can cause placenta to start dyi Continue reading >>

Gestational Diabetes And Giving Birth

Gestational Diabetes And Giving Birth

The latest guidance from NICE, published in 2015, has extended the time by which women with gestational diabetes should give birth to 40 weeks, 6 days – not much less than the general guidance for all pregnant women, which is 42 weeks. If you have not gone to birth at this point, induction of labour will be recommended. "When I was in the hospital, I felt I didn’t know what was going on. I would have liked more information about that part so I could have been better prepared." Gemma, mum of one The main reason for induction is to prevent stillbirth. For all women, the risk increases when their pregnancy goes past 42 weeks. However, one study has shown that women with gestational diabetes may be at risk earlier. So for this reason, the guidance in England and Wales states that if you have gestational diabetes, you should not go beyond 40 weeks, 6 days. An induction or caesarean may also be advised if your baby is very large (macrosomia) – as this may cause difficulties during the birth. On the other hand induction may also be recommended if the team detects poor growth in your baby. In Scotland, most women with diabetes in pregnancy are induced within 40 weeks. The guidance says that this decision should be determined on an individual basis. If you are taking diabetes medication or insulin, it recommends that you should be assessed at 38 weeks and delivered by 40 weeks. Choices you might need to make for labour and birth Most women with gestational diabetes have a healthy birth. But before you make your birth plan, you may need to take some things into account to make sure you and your baby are safe during and after the birth. If you have gestational diabetes, you will have less choice about where to deliver your baby. This is because you will need to deliver your Continue reading >>

Gestational Diabetes And Induction Of Labour – What You Should Know

Gestational Diabetes And Induction Of Labour – What You Should Know

Gestational Diabetes and Induction Gestational diabetes (GD) was once a relatively rare condition, occurring in about 4% of pregnancies. In recent years, the rate of women developing GD has doubled, and experts believe the incidence of the disease will keep increasing. Most women with GD are told by their care providers they will need to be induced before their due date, destroying their hopes for a natural and intervention free birth. Having GD can have a big impact on mothers’ and babies’ health during pregnancy, but does it really need to change how we give birth? What Is Gestational Diabetes? Gestational diabetes is a condition that only occurs during pregnancy. Certain pregnancy hormones interfere with your body’s ability to use insulin. Insulin converts blood sugar into usable energy, and if this doesn’t happen, blood sugar levels rise. Insulin resistance can cause high blood glucose levels and can eventually lead to gestational diabetes. Some women will have symptoms of GD, while others will have none. Many women can manage the condition without treatment other than dietary and exercise changes. Around 20% of women will need insulin injections. So for many women, well managed diabetes means they can still have healthy babies and normal births. Induction Of Labour Many care providers routinely recommend that women with gestational diabetes be induced around 38-39 weeks. The most common reasons given for induction at this gestation are to prevent stillbirth, and to prevent babies growing too large for vaginal birth. However, the evidence related to induction for women with GD comes from the review of one trial, which looked at 200 women who had either GD, Type 1 or Type 2 diabetes. The World Health Organization states this evidence for induction before 41 w Continue reading >>

Numbers Better At 38 Weeks?

Numbers Better At 38 Weeks?

I've been reading another post about placenta deterioration and numbers getting better and it has me a little worried. Up until this week I've had to be pretty strict with my gd diet (especially no white bread or flour tortillas). This last week I've been off my diet and numbers are in normal range, usually just over 100 after 1 hour (I need to be under 120). Fasting is consistently in the 80's even with eating a dessert for my late night snack. Anyone else in this boat and had a good growth scan in terms of placenta and fluid? I don't have my scan until Friday and will be almost 39 weeks then. Baby is really active too. I'm interested in the responses to this. I had a super low number today after a fruit salad and a cucumber sandwich (two pieces of brown bread) as a snack!! I'm 36 plus 3 and have a scan and check up in five days. My baby is also super active. I had this same occurrence starting around the end of my 35th week (currently 38.5) and neither my regular OB nor my GD specialist were concerned. Some women, especially diet controlled like me, find that everything starts to even out towards the end of pregnancy. I was told I only have to worry if my readings are in the hypoglycemic range (65 or below) consistently. I've still been following my diet, but not as strictly. I told myself that these indulgences are my reward for being such a good GD patient since week 28. :) I have experienced this as well...but only with fasting numbers not so much my other numbers. I did have a scan last week and my fluids were a little low, they were 8.5 out of 10. Everything else looked good. Doctor said it could just be dehydration but could possibly have to do with the placenta. I have another scan today so I'll find out then. I'll let you know. Just wanted to let you know tha Continue reading >>

Elcs At 38 Weeks - Normal For Gestational Diabetes?

Elcs At 38 Weeks - Normal For Gestational Diabetes?

YoungGirlGrowingOldFri 14-Oct-16 10:15:14 Can I insist it's delayed to 39 (or even 40) weeks? Background is that I failed my GTT by a whisker (0.01 mmols above normal). I have been diet controlled since then, checking blood glucose 4 times a day, completely average/normal levels of glucose (apart from 2 where I was borderline hypo My DS has always been bang on the 50th percentile for all his measurements (although he has little legs like his mum!) To my (admittedly untrained) mind, that means he is growing normally and is not affected by any high glucose levels that I may (or may not) have had during my pregnancy. ELCS was agreed at 17 weeks and the reason for it is unconnected to the GD. I understand that they may want to get GD babies out early but having also had early problems with DS' lungs, I really want him to "cook" until at least 39 weeks. I have received an appointment out of the blue for admission for ELCS at 38 weeks, midwife says I need steroids at that gestation, I don't see the consultant for another 2 weeks and I am really wibbling! Can I request a delay? Has anyone experienced an early CS where GD was being 38 weeks is early, especially when your diabetes is so well controllled. I was on insulin for mine (as neither diet nor metformin worked) and the hospital was still happy to wait till 39 plus 1 before inducing, and then induction took 2 days. I'd ask the consultant to explain why you need 38 weeks as that is odd and it makes more sense to delay. Always bear in mind you don't have to consent! Unusual to do the CS at 38weeks if it's diet controlled. Inductions arent advised until 40weeks in diet controlled GDM so not sure why an ELCS at 38weeks would be advised. I would speak to you midwife. TheWrathFromHighAtopTheThingFri 14-Oct-16 10:23:09 I didn't Continue reading >>

Anyone With Gestational Diabetes Going Past 38 Weeks?

Anyone With Gestational Diabetes Going Past 38 Weeks?

Anyone with Gestational Diabetes going past 38 weeks? Just wondered... I am going for my appointment with the antenatal team on Friday to find out if I have Gestational Diabetes (they found glucose in the urine at 36 weeks). I'm just getting a little panicky that I'm going to be whisked off to be induced as I will be 38 weeks on Sunday. I think regulations are different in the US and the UK, but I have GD and am on insulin and am being allowed to go the full 40 weeks, just not past that. I have another appt with my OB next week to see if I need metformin or not, and to start talking about induction and whatnot. I am hoping to make it to 39 weeks, and I know that my doc will STRONGLY recommend that I be induced by my due date, as the risk of placenta deterioration is apparently really high for women with GD. Never had it before - this is my 3rd baby I'm being induced at 40 wks and having a sweep at 39 wks. Was originally told I would have c sec at 38 wks if this baby shows signs of being big but they have changed their minds. Baby is showing signs of being big was est weight of 7lb 4ozs at 36 wks I'm scared tbh as my last was 10lb 4ozs and I was told I shouldn't have had him naturally due to thd extreme bruising he suffered to his eyes and forehead. Everyone seems to have different rules and guidelines As I understand it, it will mostly depend on the size of the baby hun. I would think that if you are diagnosed with GD, they will prob do a doppler scan to make sure the placenta is still working well etc. I assume there haven't been any worries about you measuring particularly big if you've got to this stage without being tested? If so, I think it's very likely they will let you go to your due date I am having a c-section between 38 and 39 weeks but that is because of ol Continue reading >>

Induction Of Labour

Induction Of Labour

In order for a baby to be born the cervix (neck of the uterus) has to shorten, soften and open and there needs to be contractions. In most pregnancies this process happens naturally between 38 - 42 weeks and is known as 'spontaneous labour'. Induction of labour is the process of starting labour artificially. Reasons for induction Prolonged pregnancy - where pregnancy continues after 41 weeks Pre labour rupture of membranes - where the waters surrounding the baby break and labour does not start within 24 hours and there is a risk of infection Medical reasons - where it is felt there is increased risk to the health of your baby or you should the pregnancy continue Does a diagnosis of gestational diabetes mean induction? For many ladies with gestational diabetes, we may fall into the 3rd reason stated above (Medical reasons). According to the current NICE guidelines induction (or elective caesarean section) should only be considered before 40+6 weeks for women with gestational diabetes if there are maternal or fetal complications. NICE (English & Welsh) guidelines: Timing and mode of birth 1.4.1Discuss the timing and mode of birth with pregnant women with diabetes during antenatal appointments, especially during the third trimester. [new 2015] 1.4.2 Advise pregnant women with type 1 or type 2 diabetes and no other complications to have an elective birth by induction of labour, or by elective caesarean section if indicated, between 37+0 weeks and 38+6 weeks of pregnancy. [new 2015] N/A for gestational diabetes 1.4.3 Consider elective birth before 37+0 weeks for women with type 1 or type 2 diabetes if there are metabolic or any other maternal or fetal complications. [new 2015] N/A for gestational diabetes 1.4.4 Advise women with gestational diabetes to give birth no later th Continue reading >>

38 Weeks Pregnant Pregnancy Week By Week

38 Weeks Pregnant Pregnancy Week By Week

You are here: Gestational Diabetes Pregnancy Tips 38 weeks pregnant pregnancy week by week 38 weeks pregnant pregnancy week by week Posted by Admin on October 8th, 2016 10:17 AM Congratulations youre now 38 weeks expecting! It is time to relax up you want to be well rested when child arrives! Make certain youre organised currently so you can take it easy. It is essential to get as much rest as you can. With your baby being a small amount restricted in movement as a result of its limited quarters, you may locate that your rest is less interfered with now, so maximize it. Rest when you can at any moment of the day. Your infant will certainly begin to involve soon, if it hasnt currently, and also you will really feel the stress of your infants directly your pelvis. Braxton Hicks tightenings will continue. Sized at roughly 49cm visit toe, your babys development is fairly secure, apart from some extension of the gain generally fat stores. Babys weight is a little under 3kg and also it is just 17 days (or two ) till you obtain to satisfy your precious cargo. SIGN UP: Have this in your inbox every week! Sign up to our Maternity Week-By-Week emails 3 things to do currently youre 38 weeks pregnant Learn every little thing you can around child sleep Many moms and dads say they desire they d recognized much more regarding infant sleep BEFORE their infant was birthed. Here are a few of the most essential points to know. First of all, newborn infants cannot remain awake for more compared to a hr approximately at once. Second of all, enjoy your baby very carefully and discover how to identify their weary signs. If they end up being overtired theyll be harder to put to sleep. Babies will certainly wake via the night for feeds, this will transform as they expand yet for currently this Continue reading >>

Late Diagnosis Of Gestational Diabetes

Late Diagnosis Of Gestational Diabetes

(links marked * are affiliate links, for more info see disclaimer below post) Well: this gestational diabetes thing has thrown a right spanner in the old works, I can tell you! (Photo above taken in last pregnancy, by the way, after I had polished off two whole desserts. I thought it was brilliantly inappropriate.) I just feel as though Ive been diagnosed (my blood sugar readings, though not horrific, definitely indicate GD) and then left just to get on with things. No real advice, no explanations as to how the condition could affect the baby, or (more my concern) how my rampantly out-of-control blood sugar levels prior to diagnosis might have affected the baby So it has been a crazy week or so of intense Google research, and speaking to my Dad and Uncle about how they keep their Type 2 Diabetes in check, and chatting to my oldest friend Tasha about how she coped during her two pregnancies with her Type 1 Diabetes. Id like to say that it has all been very interesting, and it has to a certain extent, but overall my one word to describe the situation would be: STRESSFUL. Mainly, I think, because the diagnosis has been made so late. (Im 38 weeks.) And wouldnt have been madeat allhad I not sought a second opinion about baby size from a private obstetrician. (Always trust your instincts, people.) So Im slightly consumedwith low-level fury about the fact that I wasnt given a fasting blood sugar test, despite the fact that my last baby was big and I have an immediate relative with diabetes, but Im also frustrated and confused because keeping blood sugar under control is actually quite the learning curve, and Ive been given approximately 14 days altogether to achieve it. In case you are wondering what the hell Im on about, Gestational Diabetes is a specific kind of diabetes th Continue reading >>

Gestational Diabetes 38 Weeks

Gestational Diabetes 38 Weeks

Hi all, hope you are all well! Just been to see my consultant as there was concerns our baby boy was growing big. Had a growth scan and he is estimated at 8lb 5 so not as much as a concern as we first anticipated. However, for the third time I've ++ glucose. I've already had gestation diabetes tests and twice they've come back all clear. Today I was referred to the diabetes clinic and have to monitor my bloods 4 times a day until Tuesday. If nothing happens by then they will analyse the blood results and make a decision from then as to whether I'm induced or not. I'm slightly anxious about all of this and now worrying about the complications of this effecting my baby if he is born with diabetes! Anybody else developed this later on in pregnancy and what happened about it? Hi Sarah - I could have written this exact post a week ago!! I had a hospital app last week at exactly 37 weeks and was found to have ++++ glucose in my urine. I'd already had a GTT which was negative at 32 weeks so hadnt really expected it to be such an issue. I've had a week of monitoring my bloods 4 times a day and went back to hospital yesterday (Wed) at exactly 38weeks to see what happens now. Apparently my bloods do suggest I am developing gestational diabetes and because it's late on in pregnancy and because my litttle man is measuring big (over top line but scan yesterday suggested 8 1/2lb) they've adviced induction or booking in for a section. I'd always wanted a natural birth but for various reasons I've opted for a section which has been booked for tomorrow (38+2) - am slightly shocked how quickly it's all happened and feeling a bit like it's all been taken out of my control but apparently after 39 weeks there's a chance the placenta can be affected. I changed my diet which I thought had gi Continue reading >>

Tell Me About Your Labour With Gestational Diabetes

Tell Me About Your Labour With Gestational Diabetes

Tell me about your labour with Gestational Diabetes Started by lilsunniegirl, Apr 14 2014 11:51 AM DS was born emergency csection and on time... no gestational diabetes with him Diagnosed with GD this preg. Now on night insulin and at 28 weeks was measuring 30 scans to come soon.. possibility of daytime insulin as even though diet is fantastic, doing all the right things.. cant get the blood glucose levels down consistently enough Ive been told by my midwife that they wont let me go over 40weeks with the GD she said that if they look to induce, it cant be with drip or gel due to risk of uterine rupture.. so will probably look at a balloon catheter She said Im still right to go for a VBAC, but prep mentally for a csect just in case (which I had been doing anyway) Do they induce you earlier i.e. 38 weeks? Oh, Im currently 31 weeks if that matters. I don't think I'll be of much help however I had GD with bub # 2 for me mine was managed via diet alone (thankfully). My DD was breech so she was always going to be a csection, however she came early. We were booked in for a 39 wk csection and then she decided that she would start the proceedings early so it all changed to a emergency c. For the labour part there appeared to me to be no different preparation my DS was a natural birth with no GD however I was induced via drip to move the labour along.The main differences were after she was born. DD's sugars were very low which required her to be fed immediately, however my DS his sugars were fine and he didn't feed for the first 24 hrs. My SIL also suffered from GD with her pregnancy and was on insulin to manage it. Despite her changing her diet etc they could never get her resting sugars down. Her DS was on the small side when he was born. She went through a normal labour, then Continue reading >>

Help! - Gestational Diabetes Turned Up At 38 Weeks! - Mothering Forums

Help! - Gestational Diabetes Turned Up At 38 Weeks! - Mothering Forums

First of all, don't panic. GD is not necessarily a big deal, and there are things you can do to manage it. From what you describe, it sounds like you are not a raging gestational diabetic whose sugars skyrocket no matter what you eat- you're a borderline gestational diabetic, which is something that happens to a lot of moms as pregnancy progresses. If the GD wasn't picked up until 38 weeks, and you weren't spilling sugars or ketones (that's the stuff that makes the acetone smell in your urine) until now, you were probably in the normal range throughout your pregnancy and only now have tipped over into the borderline area. It sounds like your doctor is a little bit reactionary about GD, and many doctors these days are. (Getting up on my soapbox: we're living in a culture of fear in which only 100% normal, low risk pregnancies are considered safe for vaginal delivery.) - Don't let your OB talk you into a c-section without attempting a vaginal birth first. If you already delivered a 4 kg baby, a 3.5 kg baby will be a snap. - Don't let her talk you into an induction to "limit the baby's size." First of all, it's too late to do much about your baby's size, and second, unnecessary inductions are very likely to result in more difficult, painful labors and further interventions (need for anesthesia, episiotomy, vacuum/forceps delivery, and c-section). - Don't believe everything you see on the ultrasound- they are notoriously inaccurate at predicting birthweight, and studies show that they are often off by 1 lb (approximately 0.5 k). - Do follow the GD diet- small meals and snacks combining a balance of protein and carbohydrates. - Do get some light exercise (think a 10 minute walk after every meal). - Do consider hiring a doula to give you support during your birth. - Do think Continue reading >>

Gestational Diabetes, 38 Weeks, Estimated Big Baby

Gestational Diabetes, 38 Weeks, Estimated Big Baby

Gestational diabetes, 38 weeks, estimated big baby Gestational diabetes, 38 weeks, estimated big baby Gestational diabetes, 38 weeks, estimated big baby This is my first pregnancy and I am 38 weeks today. I've been having growth scans and the one yesterday showed that the baby has gone from the 68th centile to 97th, in just two weeks. And the estimated weight has risen from 6lbs10ozs to 8lbs6oz in the same time period! I have an appointment today, and am worried that because of this massive increase they'll want to Induce me. I really wanted a water birth and to try and go naturally. But at the same time, I'm now really daunted by the estimated size of the baby. My diabetes is Type 2, and I've kept it under control with diet so I feel quite shocked at the scan results. Especially as I have only put on 2stone to date! Also I've only just begun the colostrum harvesting and only have a really small amount ready. Has anyone else had a similar experience? Have your scans always been accurate? X Continue reading >>

Does Gestational Diabetes Always Mean A Big Baby And Induction?

Does Gestational Diabetes Always Mean A Big Baby And Induction?

July 3, 2012 by Rebecca Dekker, PhD, RN, APRN © Copyright Evidence Based Birth®. Please see disclaimer and terms of use. This question was submitted to me by one of my readers, Sarah. “I have a question about gestational diabetes. It seems like everyone I know who has had it has ended up being induced. Does gestational diabetes automatically mean induction? Does it automatically mean big babies? It seems like people get diagnosed and then give up on a natural childbirth and are treated as a sick person.” I talked to Dr. Shannon (a family medicine physician), and she echoed Sarah’s perceptions about gestational diabetes: “I would say that ‘routine care’ in the U.S. is to induce at 38 to 39 weeks for gestational diabetes (leaning towards 39 weeks nowadays) if the mom’s glucose is uncontrolled or if she is controlled on medication. However, women can technically be treated as ‘normal’ if their gestational diabetes is well controlled and baby’s growth looks normal on a 32 week scan. So people just might want to know they will get major push back from their provider if they refuse induction. It’s tough. Many OB’s cite the risk of stillbirth as a reason for induction, because the risk of stillbirth in women with regular diabetes is higher. However, there is no evidence that the risk of stillbirth goes up in gestational diabetes.” Evidence Based Birth® offers an online course on Big Babies and Gestational Diabetes (3 contact hours)! To learn more, click here! Dr. Shannon brings up several good points. First, she is talking about “routine care,” which is very different from “evidence-based care.” Routine care means that this is what everyone is doing—it’s routine, it’s standard. Evidence-based maternity care means offering care that is Continue reading >>

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