In diabetes mellitus (DM), an insulin deficiency is detected in the body, which leads to metabolic disorders and pathological changes in various systems and organs.
Three types of diabetes are diagnosed:
- Insulin-dependent, or type I diabetes.
- Insulin-independent, or type II diabetes.
- Gestational occurs when a woman is carrying a child.
Gestational diabetes
The development of diabetes during pregnancy is due to the fact that the growing fetus needs additional glucose intake.
The following forms of diabetes mellitus in pregnant women are distinguished.
- Mild: fasting sugar levels do not exceed 6.66 mmol/L, and there are no ketone bodies in the urine test. Dieting is sufficient to correct glucose levels.
- Moderate severity – sugar levels reach a maximum of 12.21 mmol /l, the level of ketogenic bodies can be adjusted by diet.
- Severe form - sugar exceeds 12.21 mmol / l, the development of ketosis is observed.
What is the probability of developing diabetes during pregnancy
Although there has been a noticeable increase in patients with gestational diabetes recently, it cannot be said that there is a high probability of encountering this problem.
The exceptions are patients who have relatives suffering from diabetes, overweight women, or glucosuria (the presence of glucose in the urine). If you fall into this group, you are recommended to undergo a glucose test. If sugar levels exceed 6.66 mmol/L, a glucose tolerance test must be performed.
Examination of a pregnant woman with diabetes
The first half of pregnancy, as a rule, passes without complications.
In the second half, preeclampsia, polyhydramnios, fetal hypoxia, urinary tract infections, etc. may develop. The risk of premature birth increases.
In any case, regardless of the type of diabetes, pregnancy is managed by an obstetrician-gynecologist together with an endocrinologist.
Throughout pregnancy, it is necessary to normalize the blood sugar level of a pregnant woman, follow a diet and especially carefully prevent obstetric pathology.
Due to the increased risk of preeclampsia and other complications, changes in the patient's weight and blood pressure are constantly monitored. Also, the pregnant woman herself should pay special attention to her diet.
In the third trimester, cardiotocography, Dopplerometry, and amniotic fluid volume assessment are recommended more often than in patients with uncomplicated pregnancies. This is due to the increased risk of developing placental insufficiency and polyhydramnios during this period of pregnancy.
Usually, a cesarean section is performed with diabetes. The choice of the date of delivery depends on many factors: the form of the course of the disease, the condition of the child, the degree of compensation, the presence of possible concomitant pathology, etc. But the date of birth is usually set at 37-38 weeks.
Pregnancy planning in patients with diabetes
If a woman already had diabetes before pregnancy, it is necessary to compensate for it. After normalization of blood sugar levels, pregnancy can be planned.
Metabolic syndrome (MS) is a complex of metabolic and hormonal disorders that occur due to decreased sensitivity of muscles and adipose tissue to insulin.
Symptoms of metabolic syndrome
- Abdominal obesity (excess weight in the abdominal area)
- High blood pressure
- Increased insulin production
- Predisposition to thrombosis
- Diabetes mellitus or prediabetes
What is the danger of metabolic syndrome during pregnancy
MS threatens the development of gestational diabetes, spontaneous termination of pregnancy at an early stage, and complications during childbirth. The risk of preeclampsia increases 2-3 times, and the risk of fetal hypoxia increases 5-6 times. There is also a possibility of postoperative complications (thrombosis, infection, bleeding).
Pregnancy management in patients with metabolic syndrome
Throughout pregnancy, a patient with metabolic syndrome is shown to follow a strict diet and exercise (previously, the doctor and the patient discuss what physical activity is acceptable in a particular situation).
Screening and noninvasive tests are especially important in the first and second trimesters to rule out fetal malformations.
Due to the increased risk of preeclampsia, low-dose aspirin has been indicated since the second trimester. According to the research results, the doctor may additionally prescribe the use of low-molecular-weight heparins.
Starting from the third trimester, particularly careful monitoring of the condition of the fetus and the patient is carried out.
If arterial hypertension was detected before pregnancy, pregnancy is carried out jointly with a cardiologist. If diabetes has been diagnosed, work with an endocrinologist.
MS itself is not an indication for early delivery or caesarean section. But possible pregnancy complications can trigger an earlier birth and cause COPD.
Pregnancy planning in patients with MS
In order to reduce the risk of complications in metabolic syndrome, it is very important to undergo advanced training. It includes a thorough comprehensive examination, not only of women, but also of men, as well as correction of the condition by eliminating the symptoms of metabolic syndrome.
Advantages of contacting the EMC
- A team of specialists with extensive work experience, including in foreign clinics and hospitals.
- A full range of services in the field of obstetrics and gynecology: preparation for pregnancy, management of pregnancy and childbirth, nursing of newborns. A complete list of reproduction services.
- Modern international protocols for diagnosis and treatment.
- We specialize in complex cases of pregnancy and childbirth.
- Intensive care for patients and newborns.
- The latest operating and intensive care equipment.
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