Pregnancy - special period in a woman's life, at this time there is a rearrangement of all biochemical processes in the body and metabolism in general. All this can cause malfunctions of the body of mother and negatively affect the health of the child. One such fault is diabetes Diabetes - threatening and incurable disease   pregnant.

How and why there is diabetes in pregnancy

Diabetes in pregnancy is not an uncommon phenomenon. Increased blood sugar Blood sugar - a very important indicator   common in many pregnant women, but diabetes develops in about one in ten women. Such diabetes called gestational diabetes mellitus (GDM). The reason for increase in blood sugar in pregnant women - hormonal changes.

To understand how this happens, it is necessary to know the basic principles of carbohydrate metabolism .  Carbohydrates - a source of energy that is used for all human activities: the biochemical processes inside of his body, breathing, heartbeat, work, sports, etc. .  Carbohydrates ingested with food, enteric decomposed into simple sugars and absorbed into the blood .  From the blood glucose as a fuel is supplied to the cells - that is what sustains life in our body .  Glucose residues are converted into glycogen and stored in the liver and muscles as glucose reserves .  But glucose can not get into a cell without the hormone insulin, which is produced by special cells of the pancreas .  Therefore, even if a person's blood glucose more than normal, but not enough insulin or insulin for some reason can not do its job, the body begins to lack of energy, and violated all the biochemical processes - this is the diabetes .

The cause of diabetes is the development of the body of pregnant pregnancy hormones that inhibit the action of insulin. That is, insulin is, but inhibited its ability to be absorbed by the body of the mother. This physiological mechanism by which glucose gets to the part of the fetus. A mother's body as an energetic material starts to use fat and protein. Begin such changes in a woman's body for about 4 months pregnant. When blood sugar rises early, most likely, it is said that a woman in the past suffered latent diabetes, and pregnancy just revealed it.

A slight increase in blood sugar levels are in many women, and is developing GDM, not all, but only those women who have a certain predisposition. This predisposition to disease proceeds under the influence of factors such as obesity, age greater than 35 years, presence of endocrine diseases. To suggest the possibility of GDM in a pregnant woman can be, if it were labor, accompanied by polyhydramnios, stillbirth, a child with a large weight (4 kg or more), a child with developmental disabilities. Such women are predisposed to as spontaneous abortions and miscarriages. It has the meaning and the presence of close relatives of patients with diabetes.

After birth, all the signs disappear GDM. But it also happens that pregnancy brings out the true diabetes, who after giving birth does not pass.

Symptoms of diabetes in pregnant women

In less severe diabetes in pregnant women it can not be shown. That is why all women during pregnancy several times checked blood sugar. In more severe cases it appears dry mouth, thirst, excessive urination.

GDM complicates the course of pregnancy, there is a risk of gestosis (toxicosis of late pregnancy) with edema, high blood pressure, the appearance of protein in the urine The protein in the urine - a sign of danger, which should not be underestimated   (sign of kidney damage) and changes in the brain in the form of seizures and impaired consciousness. Women with GDM increases the risk of miscarriage, polyhydramnios, fetal birth of large (and hence complications in childbirth), and various urinary tract infections (diabetes mellitus reduced immunity).

The I - II trimester of pregnancy in healthy women fasting glucose decreases and increases in the second half. Thus, in healthy pregnant women in the blood glucose level after meal is higher than in non-pregnant women (4-5, 2 mmol / l at a rate of 3, 3 - 5, 5 mmol / L).

How does gestational diabetes in the child's condition

HSD adversely affects not only the mother but also the baby. Fetus develop characteristic changes called diabetic fetopathy. Such a child, in spite of a lot of weight (often up to 4 kg), has a functional underdevelopment of many organs and systems: the nervous, cardiovascular, respiratory, digestive, metabolic disorders, and so on. This is due to the fact that during pregnancy the fetus grows irregularly, then it slows its growth (when blood from mother to fetus receives little sugar), then accelerated (arrives too much sugar), which is caused by changing the amount of hormones in the mother's blood.

How is diabetes in pregnancy

In milder forms of GDM women are recommended to change the diet: eliminate from it all digestible carbohydrates, that is all sweet and rich. If the blood sugar level Blood sugar - one of the main indicators of human health   It remains the same or increases, the prescribed insulin preparations. Women should not be afraid of such a treatment, because it is the prevention of various complications of pregnancy and diabetic fetopathy a child.

If, despite treatment, the weight of the baby is growing very rapidly and exceeds the norm, delivery is recommended for 2 - 3 weeks ahead of schedule by induction of labor or caesarean section.

Prevention of complications of diabetes in pregnant women is regular monitoring in the antenatal clinic.

Galina Romanenko

Among obstetricians ambiguous attitude to aspirin. Many doctors recognize the positive properties of aspirin, which could be useful during pregnancy. But often outweigh its negative features, chief of which is the negative impact on the fetus.

Aspirin in the first trimester of pregnancy

In the appointment of aspirin in the first trimester (first 12 weeks), there is no disagreement: take this medication during Bookmarks organs and tissues of the fetus is dangerous, it can lead to abnormalities in the fetus. Particularly negative impact of aspirin on the development of sexual organs. For example, it is believed that this drug can cause cryptorchidism - undescended testicle into the scrotum.

The same adverse effects on the fetus and have all other NSAIDs. Therefore, they are not recommended to use as antipyretics for colds and viral diseases in pregnant women. The safest in this case is paracetamol.

Aspirin in the second trimester of pregnancy

In the second trimester (12-24 weeks) aspirin is not contraindicated, but it may appoint a doctor. During this period of pregnancy aspirin are sometimes prescribed to improve blood circulation in the placenta and the prevention of thrombosis in pregnant women.

When poor circulation in the placenta occurs fetoplacental insufficiency (FPI) - a condition in which due to insufficient blood vessel patency to the fetus receives enough nutrients and oxygen. This leads to a lag in the development of the child. But the main danger FPN is sharply negative impact on the brain of the fetus to lack of the required amount of oxygen in the blood. This can lead to serious disorders of the central nervous system of the newborn child.

Therefore FPN time trying to identify and eliminate. Including sometimes to improve blood circulation and the suppression of the formation of blood clots that disrupt blood circulation, prescribed low-dose aspirin in the form of long-term courses. However, these doses are much lower than the doses used for the purpose of analgesia or decrease in temperature, so they usually do not give side effects.

Sometimes such small doses of aspirin are appointed in severe varicose veins Varicose veins - the operation is inevitable?   women in the second trimester of pregnancy.

Aspirin in the third trimester of pregnancy

In the third trimester of pregnancy (24 to 40 per week) officially aspirin is contraindicated due to the possible threat of bleeding during childbirth. Such a threat may be real with placenta previa (when the placenta partially or completely covers the way out of the uterus), premature detachment of the placenta and in some other states.

However, aspirin in low doses are sometimes prescribed in this period if, for example, remains a threat to the development of FPN. In the third trimester of pregnancy and sometimes develops toxicosis second half of pregnancy - preeclampsia. At the heart of preeclampsia is a violation of the circulation of blood in the smallest blood vessels - capillaries. As a result, women appear at first hidden and then clear edema, increased blood pressure Blood pressure - dangerous if his swing? , A protein found in the urine (a consequence of the defeat of the blood vessels of the kidneys). If this condition is not the time to identify and treat, it will lead to serious complications of the central nervous system.

Aspirin in this case thins the blood by preventing the adhesion and platelet aggregation Platelets - what they are for the body?   (their ability to adhere to the walls of blood vessels and grouped with the subsequent formation of a blood clot). This leads to the fact that the movement of blood through the capillaries (microcirculation) improves. Of course, the aspirin in this case, is not a panacea and it is not self-appointed, but in the complex treatment.

Another indication for aspirin is premature aging of the placenta. Normally, the placenta begins to age until the end of pregnancy: zapustevayut some blood vessels, which reduces the risk of bleeding during childbirth. But sometimes the process of aging of the placenta begins much earlier norms and leads to impaired fetal growth Fetal development - week after week   and complications of the central nervous system.

Aspirin in this case is assigned with great caution, because it is always necessary to remember that the risk of bleeding during childbirth is real. However, small doses of aspirin can stop the premature aging and improve the blood supply to the placenta of the fetus.

Aspirin is a drug that in no case can not be taken alone during pregnancy.

Galina Romanenko