Gestational diabetes in pregnant women can lead to complications with the birth. There is an increased risk of pre-eclampsia and the overproduction of amniotic fluid (polyhydramnios) leading to premature labor and problems with the birth. A common problem is excess fetal growth resulting in babies that are larger than average for their gestational age or macrocosmic (over 4000g in weight). Given the possibility of these complications, induction of labor is often recommended a few weeks before the due date, but a new study has identified that there is a serious scarcity of evidence regarding this intervention.
Diabetes during pregnancy
Gestational diabetes causes a clinically significant rise in blood sugar levels during a pregnancy that, unlike Type 1 or 2 diabetes, disappears following the birth. It is caused by the insufficient production of the levels of insulin that pregnancy requires. The condition does not necessarily present with symptoms, and a blood sugar level screening test is required to identify its presence. If blood sugar levels continue to rise, the woman may become hyperglycemic, leading to an increase in thirst, urination, tiredness and dry mouth. As these symptoms can present quite frequently in normal pregnancies, they are not necessarily an indication that a woman is suffering from gestational diabetes. Women can be directed to reliable online resources; for example, you could visit remedy pharmacist for more information and should have regular screening tests during the pregnancy. The effects of the condition can be minimized by controlling blood sugar through diet and exercise changes and monitoring levels by regular testing. A dose of insulin may also be required.
Potential disadvantages of induction
The induction process aims to initiate the commencement of labor artificially by applying prostaglandin gel to the cervix, sweeping the uterus, rupturing the membrane (breaking the waters), and possibly the use of Pitocin (synthetic oxytocin). Induction has been shown to result in an increased likelihood of further intervention, for example, forceps being required to aid the birth, and women report more problems managing the labor process following an induction. Cesarean section is also more likely to be required, and being a major operation carries its own associated risks. Evidence also shows that pre-term birth can result in an increased chance of breathing problems for the baby.
Study results
A study undertaken by the Cochrane Review Group aimed to determine whether there was evidence to support induction of women with gestational diabetes. The group performed a systematic review of available literature from across the world. The results of the study have just been published, and the paper concludes that there was little available research and what could be found was of poor quality. Their analysis of this research showed little evidence to support intervention over continuing to term, and they noted a serious lack of quality research in this area. They recommend that further research is urgently needed to ascertain which approach is more likely to result in improved outcomes for mother and child.
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