Gestational Diabetes

Gestational diabetes is a disorder of sugar metabolism that occurs during a pregnancy in a patient who often has no signs or symptoms of diabetes before the pregnancy and often is no longer diabetic after delivery. While many patients who have diabetes can become pregnant and have a normal pregnancy with a healthy normal child, when diabetes is diagnosed during the pregnancy, the pregnant woman requires more careful treatment and evaluation during the pregnancy. Since diet and other measures can control diabetes during pregnancy, it is important for women who are diagnosed with gestational diabetes to be followed specifically to control their diabetes during the pregnancy. The greatest impact of gestational diabetes is that it leads to a larger baby, which is called macrosomia.

When a larger baby is delivered, the risk of a difficult labor with a shoulder dystocia and subsequent brachial plexus injury is significantly increased. Thus, when gestational diabetes is diagnosed, the obstetrician and the patient need to consider the need for a cesarean section delivery if there is evidence of a larger-than-normal size baby, or a possibility of cephalo-pelvic disproportion if the mother’s birth canal is smaller than normal.