The pregnancy of the diabetic woman can reach nine months of gestation without problems, provided that there is good control of the diabetes, without vascular or obstetric complications in the mother and if the health of the fetus is good.
However, many medical centers usually still favor delivery from the 38th week of gestation. In the case of diabetic women with kidney involvement, early birth is usually necessary.
Regarding childbirth, is admitted as a general rule, in the absence of obstetric problems, which must be normal, vaginally, spontaneously or induced. In some circumstances, typical of diabetes (large or macrosomic children, severe retinopathy, fetal distress, etc.), it will nevertheless be necessary to opt for a cesarean section.
Care for the pregnant woman and the baby after childbirth
- From the obstetric point of view, the diabetic woman will require the same care recommended for the non-diabetic woman.
- Regarding the metabolic control of diabetes in the immediate postpartum period, it is necessary to remember the need to reduce by 30-50% the daily dose of insulin that the pregnant woman had been administering during the third trimester, in order to avoid the possible appearance of hypoglycemia.
- It is convenient to insist on the benefit of breastfeeding for both the baby and the mother. Once this has been established, the need for a slight increase in the caloric intake of the maternal diet should be taken into account. Self-monitoring should not be neglected, since insulin requirements are reduced during lactation.
- At birth, the presence of a pediatric neonatologist is essential to properly examine the newborn and proceed to the recognition of possible malformations or traumatic injuries, as well as treatment, if necessary, of other complications such as hypoglycemia, respiratory distress, hypocalcemia or polycythemia.