Interview With Gynecologist of Apollo Cradle

In the past
few decades, the land of medicine has evolved tremendously regarding technology
and is going to advance even further in the coming years.

Today,
doctors can provide more efficient and better treatments to their patients with
advancements in technology. It is high time to end certain myths and facts
people tend to believe blindly, but rather need to analyze or consult doctors
before making any decision or even coming to a conclusion. Advanced treatments
and facilities are available that can identify diabetes well in advance and
treat the condition early.

Individuals
need to follow healthy practices rather than believing in myths. Remember, a
stress-free pregnancy is a healthy pregnancy.

Medindia
conducted an exclusive interview with Dr. Vimee Bindra – Gynecologist,
Reproductive Endocrinologist (Infertility) at Apollo Cradle, Hyderabad.

1. How common
or severe is gestational diabetes?

Ans: Gestational
diabetes affects 3 to 5 percent of women during pregnancy. They develop high
sugars during pregnancy. They are diagnosed as diabetic only after 24 weeks.
Uncontrolled sugars are not suitable for the baby. Sometimes, this causes
intrauterine growth restriction, prematurity, cardiac abnormalities and large
for gestational age (LGA) babies.

2. How many
mothers will become diabetic dependent on drugs after delivery?

Ans: Mothers
developing gestational diabetes could be as high as 25 percent. Oral Glucose
tolerance test is recommended for all pregnant women to closely monitor if they
are prone to develop type 2 diabetes or not.

3. What is
the most common risk factor for gestational diabetes?

Ans: The risk
factors could be multifactorial. The very first risk factor could be obesity,
multiple pregnancies, family history, advanced age, and PCOD. PCOD remains a
high-risk factor for women to develop type 2 diabetes.

4. Can
mothers with gestational diabetes have a normal delivery?

Ans: Yes,
definitely. Well controlled blood sugar levels and normal growth of the baby
can help mothers have a normal delivery with no issues at all, and a regular
checkup would be advisable.

5. What is
the link between gestational diabetes and premature birth?

Ans: Uncontrolled
sugars in pregnant woman prompt doctors to check for dopplers of the baby by
looking into the blood flow of the baby. If any discrepancy is found or the
flow is not proper, then doctors would have to deliver the baby early. If
sugars are left untreated, it can put babies at risk for
infections. General infections are more common, and the woman might even go into preterm labor.

6. Is a blood
sugar testing required after delivery?

Ans: Yes, six
weeks after the delivery, a glucose tolerance test is done once again and usually, sugar levels drop to normal after the birth of
the baby.

7. Will
gestational diabetes affect breastfeeding?

Ans: No, it does
not affect, as mothers with gestational diabetes who breastfeed their baby for
at least six months can neutralize the risk of diabetes in the mother.

8. How can
gestational diabetes be controlled?

Ans: Regular
check ups are
necessary, and if the
woman has a strong family
history of diabetes, an early oral glucose tolerance test is recommended. The mother is also put
on a strict diet control, at least 30 minutes of walking and
exercise. Fetal Ecoute checkup needs to be done to rule out the cardiac abnormalities
in the baby.

Know about
Gestational Diabetes

During
pregnancy, fluctuation in blood sugar levels and blood pressure are the most
common complications. Also, when under stress, women carrying more than one
baby tend to develop diabetes and hypertension.

Pregnancy
causes hormone shifts, psychological and physical changes, which can lead to
stress, making it more difficult to manage blood sugar and blood pressure
levels. The safety of both the mother and baby is essential. Doctors wait and
watch before they take any decision. However, when things are out of control,
extreme steps are taken.

At times like
these, if the baby is delivered ahead of time, a need for the artificial
incubator in NICU (Neonatal Intensive Care
Unit) may be required. Respiratory support is needed as the baby could
develop severe breathing problems due to the immature lungs.

If preterm
delivery is planned, an injection for lung maturity is advised by the doctors.
However, in case of unplanned emergency delivery can happen and the baby might
need surfactant for proper lung function.

The primary
cause of maternal, fetal and neonatal morbidity and mortality is the variation
in blood sugar levels during pregnancy. The fetus is at an increased risk of
Intrauterine growth restriction, prematurity, cardiac
abnormalities, large for gestational
age (LGA)
baby, and in severe uncontrolled cases may cause Intrauterine death.

Management of
gestational diabetes depends on the blood sugar levels, gestational age, blood
flow in the placenta and dopplers of the pregnant woman. Gestational
diabetes begins during pregnancy and ends with pregnancy.

References :

1. Gestational Diabetes Mellitus – (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582643/)
2. Gestational Diabetes Mellitus – (http://care.diabetesjournals.org/content/26/suppl_1/s103)

Source: Medindia