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Author Topic: Delivery in 37th week?  (Read 8207 times)
mommy_in_singapore
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« on: December 30, 2006, 08:59:48 AM »

Hi friends,

I am now in my 36th week and my doc decides to do a cesarian as i have gestational diabetes along with thalassemia...my first baby was born 3 days after 40 weeks...i am very confused and scared if this is right decision. My gynae says this is better compared to waiting and inviting complications due to sugar etc.....Huh?

Will my baby be fine? and what should be checked before deciding for c section...if anyone can guide?

Andy?
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Narendra
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« Reply #1 on: December 30, 2006, 10:03:42 AM »

Hi,

I do NOT know of a Thal deliverying early due to gestational diabetes, but know a non-thal friend who went to deliver early due to gestational diabetes. She was induced early. So, I guess gestational can be a factor

Good Luck and Keep us posted
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Andy Battaglia
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« Reply #2 on: December 30, 2006, 08:27:42 PM »

This is not an easy situation to advise as I don't have the information the doctor has. Has the doctor said that the baby has been affected in any way by your diabetes? There are some complications that can arise as seen in this article at

http://www.mayoclinic.com/health/gestational-diabetes/DS00316/DSECTION=7

Quote
Complications that may affect your baby
Consistently keeping your blood sugar levels within a normal range can reduce these possible complications:

    * Macrosomia. Extra glucose can cross the placenta and end up in your baby's blood. When that happens, your baby's pancreas makes extra insulin to process the extra glucose, and this can cause your baby to grow too large (macrosomia). For a full-term pregnancy, this means a birth weight of 4,500 grams (9 pounds, 14 ounces) or more. Very large babies may have difficulty during delivery and are more likely to sustain birth injuries or be born by Caesarean delivery.
    * Shoulder dystocia. If you have a very large baby, your baby's shoulders may be too big to move through the birth canal. This results in a potentially life-threatening obstetrical emergency, known as shoulder dystocia. In most cases, doctors can perform maneuvers to free the baby, but injuries may occur under the best of care. This is a rare but very serious complication of gestational diabetes.
    * Hypoglycemia. Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth. That's because they're accustomed to receiving large amounts of blood sugar from their mothers, and their own insulin production is high. These infants should have their blood sugar levels checked regularly after delivery. Treating this problem involves feeding right away. Your baby may even need a glucose solution through an intravenous line to prevent low blood sugar.
    * Respiratory distress syndrome. Babies born prematurely to mothers with gestational diabetes are more likely to develop respiratory distress syndrome, a condition that makes breathing difficult. It's caused by a lack of certain substances in the lungs that help prevent the lungs from collapsing every time the baby takes a breath. Babies with respiratory distress syndrome may need help breathing until their lungs become stronger.
    * Jaundice. This yellowish discoloration of the skin and the whites of the eyes is another potential complication. Newborn jaundice may begin during the second or third day of life, but sometimes isn't evident until around a week after birth. Jaundice itself isn't a disease. In most cases it occurs because a baby's liver isn't mature enough to break down a substance called bilirubin, which normally forms when the body recycles old or damaged red blood cells. Although jaundice usually isn't a cause for concern, it should be carefully monitored by your doctor.
    * Stillbirth or death. If gestational diabetes goes undetected, a baby has an increased risk of stillbirth or death as a newborn.

Complications that may affect you
If you have gestational diabetes, you may be at risk of these complications:

    * Preeclampsia. This condition is primarily characterized by a significant increase in blood pressure. Left untreated, it can lead to serious, even deadly complications for the mother and fetus. Having gestational diabetes puts you at higher risk of developing this condition, so you'll want to discuss it with your doctor.
    * Operative delivery. Gestational diabetes isn't a reason to schedule a Caesarean delivery. But your doctor may recommend one if your baby has macrosomia.
    * Gestational diabetes in another pregnancy. Once you've had gestational diabetes in one pregnancy, you're more likely to have it again with the next pregnancy.
    * Type 2 diabetes. Women who have gestational diabetes are more likely to develop type 2 diabetes — a type of diabetes that's present all the time, not just during pregnancy — as they get older. Many cases of diabetes can be prevented with a healthy diet and regular exercise.


Has the doctor mentioned any problems that you or the baby have? If there are none, I see no reason to have a c-section other than doctors often prefer the controlled nature of the c-section.

From http://www.marchofdimes.com/professionals/14332_1197.asp

Quote
What tests are recommended to detect complications?
The doctor will carefully track the size and well-being of the fetus, especially during the third trimester of pregnancy. He or she may recommend one or more ultrasound examinations to assure that the fetus is growing at a normal rate. If the baby reaches a weight of 9 pounds, 14 ounces or more, the doctor will likely recommend a cesarean delivery at term. The doctor also may recommend a nonstress test (which may be repeated weekly or more frequently), a procedure that monitors the baby’s heart rate. In most cases, these tests will show that the pregnancy is progressing normally. Although women with diabetes are at increased risk of cesarean delivery, most have normal vaginal deliveries.

It is hard for me to say whether a normal vaginal delivery would be safe. Only your doctor can make that judgement. However, doctors often push for c-sections anytime there is any chance of risk or when there has been a previous c-section (even though it is well known there is no reason for this and women who have had a prior c-section can deliver vaginally just as any other woman), so you need to know on what the doctor is basing his decision. Is the doctor pushing for an early c-section? If so, why? If there is nothing that suggests potential problems, I don't agree with a c-section. A closely monitored vaginal delivery may be just as safe if there is no other problem going on.



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Andy

All we are saying is give thals a chance.
Narendra
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« Reply #3 on: December 30, 2006, 10:23:32 PM »

Andy is right.. I talked with my friend who had gestational diabetes and she mentioned that the reason why they try to get the baby early is due to the weight gain. if the baby gains more weight, it might cause problems. Although, don't know why C Section is set up. Your doctor should be able to answer it. The doctors might be able to know what the weight of the baby might be, but I dont understand why are they NOT going for the induce option.

-Narendra
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Courtenay1826
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« Reply #4 on: January 06, 2007, 06:48:42 AM »

My baby Mychael was taken via c-section at 36 weeks due to my thalassemia causing some complications.  He did perfectly well...the doctors will probably just check your baby over very well and check its sugar levels more than usual, b/c of the gest. diabetes.  They'll also test fetal hemoglobin, etc.  Mychael is now a very healthy 1 month old...Don't worry! Being calm is the first step to success right now. 
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