What are the risks of diabetes in pregnancy?

Diabetes is a common health problem. Women with diabetes have increased risk of having problems or complications in pregnancy. The risk also depends on how long diabetes has been present and if there are complications such as high blood pressures and kidney damage. Women with poorly controlled diabetes in early pregnancy have a two to four times increased risk of a birth defect in the baby such as heart defects and neural tube defects. In the later part of preganncy, there

is an increased risk of having a large baby (macrosomia) that may necessisate a Caesarean delivery. Stillbirths tend to be more common and pre-eclampsia risk is increased.

The baby’s lungs mature more slowly and newborns of diabetic women have increased risk of respiratory distress syndrome, hypoglycaemia (low blood sugar), low calcium and high bilirubin levels in the blood. These substances are routinely measured in babies of diabetic mother. (Bilirubin is the waste product that results from the breakdown of haemoglobin molecules from worn out red blood cells. It is excreted from the body as the main component of bile. Excessive levels of bilirubin turn the skin yellow. Very high levels of bilirubin in the bloodstream can cause permanent brain damage in newborn infants.)

Effects of Diabetes on the Mother:                              

• High blood pressure, pre-eclampsia.                                        
• Worsening kidney damage.

• Worsening retinopathy (eye damage).                                       

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• Urinary tract and other infections.
• Polyhydramnions (increased liquor).
• Malpresentation, premature labour (increased possibility).
• Instrumental delivery (increased possibility).
• Caesarean births (increased possibility).

Effects of Diabetes on the Baby:

• Macrosomia (big baby).                                       
• Growth restriction (problems with growth).           
• Birth defects.                                                                               
• Stillbirths.                                                                 
• Respiratory distress syndrome.
• Glucose (lower level).
• Calcium (lower level).
• Bilirubin (higher level).                                        
• 2% risk of diabetes by age 20 if only mother has diabetes; 5% if father alone has diabetes.    

                                                                                

Based on Is My Pregnancy Normal?, Dr.Patrick Chia & Dr. S. Raman, 2005, Discern Publishing House Sdn. Bhd.  

I`m HIV positive and i'm pregnant. What should i do?

The human immunodeficiency virus (HIV), or sometimes referred to as AIDS virus, attacks the body’s immune system and render it too weak to cope with infection and certain tumours. The latter stage when this happens is called AIDS (acquired immune deficiency syndrome). The progression to full-blown AIDS can now be controlled with modern-day antiviral therapy. HIV is acquired through sex and through blood such as when needled are shared between intravenous drug abuser.

 

 

 

 

  

Being HIV positive has tremendous implications to both the mother and her baby. HIV does     not usually worsen in pregnancy. There is no evidence of pregnancy increasing the risk of progression of the disease. However, women with HIV tend to have an increased risk of miscarriage, intra-uterine growth restriction, premature births and low birth-weight babies. These complications reflect more on the mother’s state of health rather than the virus itself. The current antiviral treatment does not appear to cause any foetal abnormalities

Many issues need to be considered in an HIV positive woman who is pregnant. Combined care with an HIV expert is essential to reduce the risk to both the mother and her baby.

Based on the New York Heart Association’s classification