Pregnancy Safety Precautions NEW YORK, May 3, 2003 (CBS) Alisa Kotler-Berkowitz and her son Matan are the picture of health today, but two-thirds of the way through her pregnancy, Kotler-Berkowitz got an unexpected diagnosis. She learned she had gestational diabetes. "I was concerned because I wasn't sure what it meant, I didn't know a lot about diabetes," says Kotler-Berkowitz. A woman with gestational diabetes produces the right amount of insulin, but the insulin's effects are blocked by hormones made in her placenta. It's a condition that affects between 3 and 6 percent of non-diabetic women. Risk factors include a family history of diabetes, high blood pressure, obesity and being over the age of 30. "It is very important that we screen pregnant women because there are no symptoms," says Mt. Sinai Hospital's Dr. Michelle Morgan. Women are tested for gestational diabetes between the 24th and 28th week of pregnancy. They begin by drinking a sugary solution. After one hour, their blood is drawn to check the glucose level. If it's too high, the expecting mom will have to undergo further testing. If it is determined a pregnant woman does have gestational diabetes, she must get it under control immediately. Failure to treat the condition can lead to serious problems for the baby, including excessive birth weight, low blood sugar, jaundice, respiratory problems and sometimes death. In most cases, gestational diabetes is fairly easy to deal with. "The main stays of treatment generally consist of a program of diet and exercise, and in some cases if the diabetes is not controlled, an addition insulin would be used," says Morgan. Kotler-Berkowitz keeps her diabetes in check by following a healthy diet she hopes to maintain. "Lately I've rediscovered my love for chocolate so I'm sort of thinking about it, remembering my diabetic diet." Dr. Mallika Marshall from WBZ-TV explained on The Saturday Early Show that regular exercise and a healthy diet have been shown to lower the chances of diabetes in people who are at risk. There's also a medication, called Metformin, that can help prevent diabetes in people who have mildly elevated blood sugar levels high enough for a diagnosis of diabetes. Another problem some pregnant women may be concerned about is preeclampsia, says Marshall. It is commonly known as toxemia, or pregnancy-induced hypertension. It only occurs during pregnancy and affects about 5 percent of pregnant women in the United States. It usually develops in the second or third trimester. Women with preeclampsia develop high blood pressure, protein in the urine and swelling of the legs, hands and sometimes the entire body. In rare cases, women can develop seizures and can even die from the condition. The cause of preeclampsia is unknown, but it results in constriction of the blood vessels in the mother, which can decrease blood flow to placenta and to the fetus. This can slow the baby's growth. Marshall says some women may develop swelling, headaches, blurry vision or abdominal pain if they have preeclampsia. But many women don't develop symptoms at all. That's why it's so important that pregnant women get regular prenatal care and have their blood pressure checked throughout their pregnancy. The only cure for preeclampsia is to deliver the baby, because it resolves itself as soon as the pregnancy is over. If the symptoms are mild and it's too soon to deliver the baby safely, the woman will usually be put on bed rest and will be monitored closely by doctors and nurses. Sometimes women are hospitalized and treated with intravenous medications. But if symptoms are severe or the woman develops seizures, the baby has to be delivered. Another problem to be on the lookout for in the later stages on pregnancy is bleeding. Some women may suffer from placenta previa, which happens when the placenta is located in an abnormally low position in the uterus, partially or completely blocking the cervix. In some cases, as the pregnancy progresses, the placenta changes locations and no longer obstructs the cervix. In some cases, a C-section is required for delivery. In placental abruption another pregnancy-related problem, a part of the placenta detaches from the wall of the uterus, and can cause pain and bleeding. If minor, bed rest may be all that's required. If severe, the baby may have to be delivered by C-section. Marshall says pregnant women with asthma are also at high risk of endangering their unborn child. About a third of women with asthma will notice their asthma symptoms worsen during pregnancy. However about a third of women get better during their pregnancy. Severe uncontrolled asthma can reduce the supply of oxygen to the baby and can increase the risk of premature birth. Source: CBSNews.com