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Risks posed by gestational diabetes Glucose challenge test does not affect fetus How is blood glucose analyzed in pregnancy? Treatment of gestational diabetes Benefits of glucose challenge test in pregnancy

Do not beware of glucose challenge test in pregnancy

Gestational diabetes implies carbohydrate intolerance in the pregnancy. If the gestational diabetes is left untreated, it may lead to significant problems in fetal health.


Risks posed by gestational diabetes

The risks posed by gestational diabetes on the fetal health include macrosomia (a newborn larger than average), shoulder dystocia, neonatal respiratory distress, low blood glucose in newborn infant, low calcium level, jaundice, pediatric diabetes, obesity, increased volume of amniotic fluid and preterm delivery as well as intrauterine death if the maternal blood glucose is not regulated.

The short-term maternal risks posed by gestational diabetes are miscarriage, preeclampsia, infections, difficult birth, operative delivery (vacuum-assisted delivery or Caesarean section), postpartum bleeding and recurrence in subsequent pregnancies. The long-term risks are evident diabetes mellitus and metabolic syndrome.

Scientific evidences have proven importance of laboratory-based tests/screening with blood glucose analysis in all pregnant women to ensure fetal and maternal health. The screening should be started at 24 to 28 weeks of the gestation for women with glucose intolerance documented in early pregnancy. The glucose challenge test does not harm the mother and the fetus.

Glucose challenge test does not affect fetus

The glucose challenge test does not have a significant effect on fetal acid-base homeostasis in healthy pregnant women. The placenta has a special diffusion system that ensures glucose transfer between the mother and the fetus; the baby is not influenced by sudden-onset increase of glucose in maternal blood after an oral glucose tolerance test. International scientific guidelines and societies recommend screening for gestational diabetes mellitus in all pregnant women.

How is blood glucose analyzed in pregnancy?

The mother is asked to drink a fluid that contains certain amount of glucose in the glucose challenge test. In the two-phase approach, 50-gram oral glucose tolerance test is performed at 24 to 28 weeks of the gestation (for women with no history of glucose intolerance) and it is followed by 100-gram, 3-hour diagnostic oral glucose tolerance test (OGTT). To establish the diagnosis, two or more blood glucose readings should be above the cut-off value in the 100-gram OGTT. In the single-phase approach, 75-gram, 2-hour OGTT is performed at 24 to 28 weeks of the gestation (for women with no history of glucose intolerance). To establish the diagnosis, one or more blood glucose reading should be above the cut-off value in the 75-gram OGTT.

Treatment of gestational diabetes

After a pregnant woman is diagnosed with gestational diabetes, she will need eating and exercise counseling. If the blood glucose cannot be regulated well in response to diabetic diet and exercise, medication treatment (insulin) is started for the sake of maternal and fetal health. Insulin does not harm the baby, as it cannot cross the placental barrier.

Benefits of glucose challenge test in pregnancy

The risks posed by gestational diabetes on the mother and the fetus can be prevented or reduced with this test. These risks are as follows:

  • Gestational hypertension,
  • Preeclampsia,
  • Caesarean section,
  • Macrosomia (a baby larger than average),
  • Neonatal hypoglycemia (low blood glucose),
  • Neonatal hyperbilirubinemia,
  • Shoulder dystocia,
  • Labor trauma,
  • The long-term risk of evident maternal diabetes in the postnatal period.