All this talk of being induced has me a little confused. Do some doctors just induce because you have GD? I have been told I will likely have lots of ctg monitoring and ultrasounds from 38wks to keep checking cord blood flow and placenta, but if all is ok he is happy to let me go to 42wks so that I risk less intervention. My levels have been really good and if they're under control, apparently there is no need for concern and I should be able to go into labour on my own.
It just seems like such a grey area and everyone has a different opinion. It seems the majority of people with GD are induced but I dont really understand the reason why.
Megan from what i have been told there are two reasons...
1. possibility of macrosomia ie. big fatty boomba baby! leading to difficult delivery because of shoulder dystocia (getting stuck). interestingly though a macrosomic baby has a normal size head usually and it is the body that grows out of proportion hence difficulty maneuvering through the birth canal.
2. slightly increased risk of stillbirth in GD. Some studies show that from 38 weeks onward the placenta MAY begin to break down earlier and/or faster than in a PG without GD. Hence the extra monitoring.
I will be having weekly CTG's from 32 weeks on and am having 4 weekly growth scans already. And have been recommended to have this baby between the 37 and 38 weeks mark, one way or the other.
ie naturally, (hopefully) induced or ceasarean.
Still not sure how its all going to go... seing the OB next week to discuss it further. But different Doc's have varying opinions on risks etc. so they will steer you more in the direction that THEY feel is best for you and bub.
Megan with all type of diabetes there are risks to the baby. The risks are not so much these days with better monitoring techniques etc but a lot of obstetricians are stuck in the conservative better out than in policy. Rare risks include placental degradation without warning as with diabetes everything develops earlier and therefore gets to the point of degrading earlier....it used to be a significant risk but now with CTG, regular ultrasounds it is something that can be better managed. Also there is a risk of macrosomia if th diabetes is uncontrolled.....macrosomia doesnt just mean a big baby, it means a disproportionally big baby....one with a much larger stomach than head. This means you birth the head part all hunky dorey but then baby gets stuck.....big issues can occur. Again this was a real risk in the past but not so much these days if you are well monitored. And then again the opposite can occur where you get growth retardation due to excessive sugar levels impeding the circulation of important growth nutrients through the placenta...this is more an issue with long standing diabetics whose general circualtion can be impaired not so much GD'ers.
So you can see why some OBs take a conservative approach especially around the 38 week mark.......you are lucky to have found an Ob who is more up with the play on modern monitoring techniques and focussed on the reality of these small risks rather than the hype that surrounds them.
You hear stories all the time (and i have seen some posted here in the news sections) about women who have birthed like 15lb babies and it says in the article that the woman had GD. This invokes fear in a lot of people espesh those who are pregnant themselves. the reality is that those women would have had to have had uncontrolled, severe GD and been uncompliant to treatment plans in order to grow such a big baby with such health issues. People like the responsible ones I see on these forums are doing the right thing by minimising the risks and monitoring things etc and they have all gone on to have healthy happy babies whether induced early or gone to term.
If your doctor wants to induce and you are not happy with that then i would ask a lot of questions about the why they want that....push for regular monitoring etc if you think it is just the GD that is influencing their decision.....but if you are happy to be induced then thats okay too....at least all the testing and injecting will be over!!!
I hope this makes sense...was just trying to answer megans questions and it has turned into a bit of a ramble!
Thanks for all that info mel I just wanted to make sure I wasn't missing something with regards to how my situation is being dealt with. Obviously I would prefer to go into labour spontaneously, but not at any risk to the baby. The OB and endo are both really happy with how things have gone, I was diagnosed early and it's been well controlled (bsl average at 5.4) which I guess is why he is happy to let me go with the extra monitoring at 38w rather than being induced then. Still a bit of a way to go until then, and anything can happen but I just needed to be clear that I didn't have any other reason to question him, and there were no other risks I hadn't been made aware of.
Myson, a big fatty boomba baby....when I had my 4d scan the lady told me he had really chubby cheeks and they're the first words that came to mind!! lol I'm hoping it's not a sign!
Megan, my Dr told me that because of the GD there wouldn't be any way that she'd let me go past 40 weeks because of the deterioration of the placenta and size of bubs.... At my scan at 33w 3d bubs was measuring 13 days ahead at nearly 6lb..... On Tues bubs was only 6 days ahead at 7lbs 13oz....... And now with the high BP she's concerned that the nutrients aren't getting across the placenta to bubs which is why she's looking at inducing me next week...... But if it stays down, which it has for the last 3 days without meds I'm hoping that I'll be left to go into labour naturally, unless I go over the 40 week mark.....
I think alot depends on your Dr, and the monitoring they have available to them...... Mine has everything available, which is why she has only said she's looking at inducing, it's not quite a definate yet......
Thanks Vanessa. I'll be happy to go with the extra monitoring from 38w and see how things go from there. I have been told over and over by my DE, OB and midwife that if my levels are controlled then there should be no effect on the placenta and I would be treated like any other woman, but the extra monitoring will be available (which obviously I would take). Then I keep seeing women (at the hospital I go to with private OB's - I'm public) where they have been induced as early as 34wks because they have GD and these women had not had any growth scans, or other monitoring. The fact they had a GD diagnosis was enough for the OB to induce early. I guess I should be happy my dr is not booking me in for an induction next week, but hearing of 2 women I know being induced at 34w with controlled GD has had me in a bit of a panic.
Megan, I would be worried if they are happy to induce at 34 weeks too.... That is a little too early for my liking, just my opinion though...... Bubs lungs aren't fully developed until 38 weeks, and there isn't enough surfactant in the lungs prior to that to make an easy start to life...... This is why my doc is hanging off til next week anyway.....
If your levels are good, I'm sure that you'll be fine, I think it is more if you are looking like you are gonna go past 40 weeks that they'll make the decision to induce...... Or if you get a secondary condition like me.... GD does put us at higher risk of having hypertension, which they want to prevent from developing into preeclampsia....... So I think a lot will also depend on what your BP does in the last few weeks...... Mine had been great until last Tues when it went up, then down, then up again on the weekend..... Now it is down again and we are playing the game of wait and see.....
I just wanted to make sure I wasn't missing something with regards to how my situation is being dealt with. Obviously I would prefer to go into labour spontaneously, but not at any risk to the baby. The OB and endo are both really happy with how things have gone, I was diagnosed early and it's been well controlled (bsl average at 5.4) which I guess is why he is happy to let me go with the extra monitoring at 38w rather than being induced then. Still a bit of a way to go until then, and anything can happen but I just needed to be clear that I didn't have any other reason to question him, and there were no other risks I hadn't been made aware of.
a big fatty boomba baby....when I had my 4d scan the lady told me he had really chubby cheeks and they're the first words that came to mind!! lol I'm hoping it's not a sign!
And now with the high BP she's concerned that the nutrients aren't getting across the placenta to bubs which is why she's looking at inducing me next week...... But if it stays down, which it has for the last 3 days without meds I'm hoping that I'll be left to go into labour naturally, unless I go over the 40 week mark.....
Now it is down again and we are playing the game of wait and see.....
Bookmarks