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In our last post, we discussed the basic differences between type 1 and type 2 diabetes and concluded with the characterization of gestational diabetes mellitus(GDM), diabetes that is first expressed(or detected) as the result of pregnancy, as fit...
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Back in August of this year, I started a series on Diabetes in Pregnancy. A recent reader reminded me that I hadnt gotten around to finishing that series(which is true because I got distracted by other topics).
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In our last post, we discussed the preconceptional evaluation of the woman with pregestational diabetes this evaluation pertains to women with either type 1 or type 2 diabetes. As part of the evaluation, we mentioned screening for hemoglobin A1c a...
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Gestational diabetes mellitus(GDM) and type 2 diabetes comprise more than 95% of the diabetes complicating pregnancy. Both are characterized by a relative(not absolute) deficiency in insulin as the result of inadequate production/secretion, periph...
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In our last two posts on diabetes in pregnancy, we discussed the importance of diet and exercise and the value of self-monitoring as the foundations of blood sugar control. If these measures fail to achieve normalization of blood sugars(fasting va...
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After discussing the basics and importance of diet, the next step in counseling for the newly diagnosed woman with gestational diabetes mellitus(GDM) revolves around the means of assessing her diabetic control. The mainstay of management is freque...
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I will explain what Class R/F means later on but, simply put, its not good because both her kidneys and her eyes have suffered severe damage from long-standing poorly-controlled diabetes. The outcome of pregnancies under these circumstances is usu...
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Although I have left the discussion of pregestational diabetes until the end of our series on Diabetes in Pregnancy, that was not done with the intent of diminishing its significance with regard to maternal and fetal morbidity and mortality. Even ...
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Once we have established the diagnosis of gestational diabetes mellitus(GDM), the first step in management is to counsel the patient regarding the diagnosis, management options, potential risks to the pregnancy, antepartum assessment of the baby, ...
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In our second post on diabetes in pregnancy, we gave a simple overview of glucose metabolism and discussed the essential role insulin plays in assuring that glucose gets into the cell. Pregnancy alters the normal balances involved in glucose metab...
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To continue the discussion of diabetes in pregnancy, lets first start with a very simplified review of glucose metabolism and the role of insulin so that we understand what the furor is all about.
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The guidelines for weight gain during pregnancy are pretty straightforward:.
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Before I get into details regarding specific abnormalities of the maternal immune system and clotting system that appear to be related to recurrent early pregnancy loss, let me tell you a story about one of those special patients in my life who ch...
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Below are excerpts from a comment/query that appeared recently on my post Recurrent Early Pregnancy Loss-6- A Special Patient. In this post, I recount my first experiences with a woman who had pregnancy complications(miscarriages and severe preecl...
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In the last couple of posts we have reviewed causes and complications related to excessive amniotic fluid, otherwise known as polyhydramnios or, simply hydramnios. Although 50-60% of cases of hydramnios are idiopathic(no identifiable cause) and ab...
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Anyway, surprise to us we became pregnant however the baby turns out, having an amniocentesis or any other genetic testing is irrelevant. Now at 19 weeks we had a 2nd ultrasound and my baby was found to have a Choroid Plexus Cyst one measuring app...
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Soumya has left a new comment on your post" Recurrent Early Pregnancy Loss- 6- A Special Pat...". (I have modified/revised her comment somewhat to the best of my understanding of her concerns)...
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Attached is a comment from a reader who has written to me before because of a history of recurrent early pregnancy losses. She is now pregnant, has successfully gotten through first trimester, and has had very reassuring combined risk assessment f...
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The"back ache" could also be uterine contractions associated with miscarriage or caused by something outside the uterus such as an ectopic pregnancy or ovarian cyst. At 7 weeks, your doctor can do a transvaginal ultrasound and should be able to co...
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For many years now, we have placed women with recurrent early pregnancy loss on low-dose aspirin(81 mg) and heparin, or low molecular-weight heparin such as lovenox, to help them improve their prospects for pregnancy outcome. In some instances thi...
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Within the past week the National Center for Health Statistics released its annual report on mortality in the U.S. for the year 2004(National Vital Statistics Reports. 2007. 55;19) Buried as the last area of comment in the report were the maternal...
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Recently, I received the following two comments from readers regarding their concerns about the use of 17-hydroxyprogesterone caproate or 17P(formerly known as Delalutin) in the management of preterm labor. Their specific concerns are related to t...
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Today I received another comment to a post I wrote awhile back on aneuploidy(chromosomal abnormality) from a reader who has a first trimester baby that was found to have a cystic hygroma. With the growing acceptance of first trimester screening fo...
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