Metaglip (Glipizide, Metformin)
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| medrx-one "Generic Metaglip" | 2.5mg + 250mg | 10 days/free | | most countries | |
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DIABETES IN WOMEN: DELIVERY
In the old days, diabetic women were admitted to the hospital for months during their pregnancy, their babies were induced several weeks early and caesarian section was commonly performed. This was partly because poor glucose control led to very big babies. Nowadays, many obstetricians experienced in caring for diabetic women allow the pregnancy to come to term and vaginal delivery to take place.
Labour
When you go into labour, careful and continuous monitoring of you and the baby is started. A continuous glucose infusion is run into a vein with a continuous insulin infusion running at the same time. The rates of glucose and insulin infusion are adjusted according to your blood glucose levels. You will be given plenty of glucose because labour, as its name suggests, is hard work and if you do not have enough glucose, ketones will form which may harm the baby.
Do not be alarmed if a pediatrician or neonatologist is there when your baby is delivered. This is a precaution in case the baby has blood glucose problems while it is adjusting to living away from you. These are easily treated. Occasionally, babies of diabetic mothers have early breathing problems and these can be treated too. Sometimes, if there has been a period of poor glucose control during pregnancy, and occasionally even with perfectly controlled mothers, the baby is very large. If this happens you may need a caesarian section and the baby will probably be admitted to the special care baby unit for a few days. Your baby will be back with you as soon as the doctors have made sure that his or her glucose level is normal and the breathing is all right. The baby’s weight will soon level off to match other babies of the same age.
Within a few hours of delivery your insulin requirements will drop dramatically. Therefore it is important that your glucose drip is not taken down until you are eating properly.
Today most diabetic women have healthy babies. If something goes wrong, do not blame yourself. Remember that a very small proportion of non-diabetic women also have babies with congenital problems, for no obvious reason. All you can do is try your best to keep yourself healthy during pregnancy and to keep your blood glucose normal; no one is perfect and no one can do more than her best.
Expert care
By now you will have realized that ensuring that women with diabetes keep well during pregnancy and labour and have healthy babies is a complex business. It is much better to travel a few extra miles to a hospital that has a special clinic for diabetic mothers than to go somewhere closer to home which rarely sees a pregnant woman with diabetes. Your diabetes adviser will know of local diabetic prenatal clinics, and he or she may even share one with an obstetric colleague. If you have difficulties in finding expert care, your diabetic association (the American Diabetic Association – ADA – or the British Diabetic Association – BDA) may be able to tell where your nearest diabetic prenatal clinic is. Home deliveries are out of the question for the diabetic mother-to-be.
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