Growth and Development Q 48
A 27-year-old woman has Type I diabetes mellitus. She and her husband want to have a child, so they consulted her diabetologist, who gave her information on pregnancy and diabetes. Of primary importance for the diabetic woman who is considering pregnancy should be:
A. Early prenatal medical care
B. A review of the dietary modifications that will be necessary
C. Understanding that this is a major health risk to the mother
D. Adoption instead of conception
Correct Answer: A. Early prenatal medical care.
Pregnancy makes metabolic control of diabetes more difficult. It is essential that the client starts prenatal care early so that potential complications can be controlled or minimized by the efforts of the client and health care team. The woman does need to be proactive in her diabetes care prior to pregnancy to optimize her health and her baby’s and prevent possible complications.
Option B: The doctor may refer the woman to a diabetes educator and/or a dietitian to help her with a meal plan and blood sugar management. A review of dietary modifications is important once the woman is pregnant. However, it is not of primary importance when considering pregnancy.
Option C: While there is some risk to the pregnant diabetic woman, it is not considered a major health risk. The greater risk is to the fetus. Other potential risks of poorly controlled diabetes in pregnancy include low blood glucose in the baby at birth, a large baby, or under certain circumstances, a growth-restricted baby.
Option D: The alternative of adoption is not necessary just because the client is a diabetic. Many diabetic women have pregnancies with successful outcomes if they receive good care. Having diabetes, especially with out-of-control blood sugars, increases the risks of pregnancy. However, with good planning and blood sugar control, the risks can be lowered.