Althought your pregnancy won’t be considered high risk just because you are over 35, your age does mean that you might be more likely to have or to develop a problem that results in extra monitoring, tests or treatment. Some conditions develop during your pregnancy, others conditions, such as high blood pressure, make your pregnancy high risk from the start.

Gestational Diabetes

Gestational diabetes is a disorder of sugar (glucose) regulation that occurs specifically in pregnancy. It means that your body’s ability to regulate your sugar levels is not up to the strain of pregnancy.

Normally, sugar levels are regulated by a balance between two hormones insulin (produced in your pancreas) and glucagon (made by your liver). Insulin is released when your blood sugar levels rise after eating, allowing your body to remove excess sugar from your bloodstream. Glucagon is released when your blood sugar levels are low, triggering a rise in your blood sugar levels.

Diabetes And Labor

Women with gestational diabetes requiring treatment are at increased risk of having a large baby the risk depends partly on how well blood sugars are controlled during your pregnancy. If you have diabetes, your doctor will usually estimate your baby’s birth weight before you go into labor, either by feeling your baby through the uterus or using ultrasound. If your baby is normal size, your physician may induce labor at 39 weeks because of the increased risk of fetal complications in prolonged pregnancy in women with diabetes. During labor you will need to have an IV and your blood sugars will be carefully monitored every hour or two. If your baby weighs more than 9-9½1b (4 to 4.5kg) there is a risk that the shoulders may get stuck (known as shoulder dystocia), which increases the chance of a birth injury or other serious complications. Your physician will talk to you about this risk and may offer you a cesarean delivery.

Type Of Diabetes

In gestational diabetes, your body either fails to produce enough insulin to cope with the strain of pregnancy or your body’s cells are resistant to insulin’s action. This is similar to type 2 diabetes (sometimes called adult onset diabetes). Type 1 diabetes, which usually begins in childhood or adolescence is different in that the pancreas doesn’t make any insulin. During pregnancy, your placenta produces a hormone called human placental lactogen (HPL), which makes your blood sugar levels rise. As a result of this, your body has to produce more insulin to maintain normal sugar levels. Gestational diabetes will disappear after your pregnancy is over, but you are much more likely to develop type 2 diabetes later.

How Is It Diagnosed?

Gestational diabetes is initially detected in the third trimester of pregnancy by a one-hour glucose test a screening test to identify women at a higher risk of sugar problems. Women who are found to be at risk then haw diagnostic test called a glucose tolerance test to determine whether or not they have gestational diabetes. This test is very similar to the one-hour test, but you have to get your blood drawn four times instead of just once. Blood glucose levels are checked when you haven’t eaten anything (fasting), then 1, 2, and 3 hours after you drink a second sugar drink. If your blood sugar levels are high after your 3 hour glucose test, it means your body was not able to handle a sugar load and you have gestational diabetes. Different care providers may use slightly different sets of criteria to diagnose gestational diabetes based on your blood test. Some doctors may consider a particular glucose tolerance test result borderline, while others will want to monitor and treat you actively.

Cervical Insufficiency

This is an uncommon condition, sometimes known as cervical incompetence, where the cervix opens (dilates) without you having contractions. Cervical insufficiency can be a cause of miscarriage in the second trimester. If you have miscarried in the second trimester in the past .with out having painful contractions your care provider may recommend you have a cerclage in this pregnancy. A cerclage is a stitch that is placed around the cervix to keep it tightly closed, rather like a drawstring around the neck of a balloon. An alternative to a cerclage, in some cases, is for you to be monitored with a transvaginal ultrasound weekly or every other.

How Is It Treated?

In most cases, gestational diabetes can be treated by adjusting your diet to reduce your carbohydrate in take. Your care provider may suggest you see a nutritionist, who will advise you on what you can and cannot eat. You are likely to be told to eat unrefined, complex carbohydrales such as wholemeal bread, rice and pasta and to avoid cakes, sodas, and sweets. Your care provider will monitor your blood sugar on your new diet. Your blood sugar may have to be tested up to four times a day at home, and you will be expected to do this testing yourself using a simple, handheld glucose monitor. If your blood sugars remain high, you will need to have insulin injections (twice a day injection) or possibly a glucose-lowering pill.

Future Risk Of Diabetes

If you develop gestational diabetes during your pregnancy you are more likely to develop type 2 diabetes later in life. You should be tested for diabetes with a blood test (after another glucose drink) 6 weeks after your pregnancy, and then at regular intervals after that. week. A small ultrasound probe is inserted in the vagina and the cervix is imaged on a screen.

If your cervix shows signs of opening up, your care provider may recommend you have a cerclage at that point. Sometimes changes in your cervix are noted during a routine, second trimester ultrasound. In this case, if you’ve not had a miscarriage before, it is controversial whether placing a cerclage is helpful. Your care provider will review the risks and benefits with you or refer you to a specialist for consultation.