Definition

Gestational diabetes occurs when the body’s usual handling of sugars doesn’t work properly which creates a condition similar to diabetes for the duration of the pregnancy. If there are any symptoms they are a result of high blood sugar.

Symptoms

• feeling thirsty
• feeling the need to urinate often
• tiredness

but quite often there are no symptoms.

Diagnosis

When this is suspected, blood tests are carried out (glucose tolerance test) which reveals whether sugar (glucose) is being appropriately cleared from the body or not.

Treatment

If gestational diabetes is diagnosed, a diet change and self checking of sugar levels may be needed. Sometimes women may need to be started on tablets or insulin. Gestational diabetes usually gets better once the baby is born, but this does need to be followed up. At OBGYN Matters we work closely with a team of diabetic specialists to manage the pregnancy.

Symptoms

Obstetric cholestasis (OC) is a condition which can complicate pregnancy, especially in later stages. It is characterised by:

• itching (especially on the palms of hands and soles of feet).
• Obstetric cholestasis is characterised by elevated liver enzymes, which are picked up by blood tests.

Treatments:

When OC is suspected, the pregnancy will need to be monitored more carefully and sometimes early induction of labour is necessary. The management is controversial therefore research into this condition is ongoing and at OBGYN Matters, Alison Wright is involved in research looking to find the best way to manage these pregnancies. The British Liver Trust is the national charity working to reduce the impact of liver disease in the UK, including Obstetric cholestasis.

Symptoms:

Pre-eclampsia is a condition which can complicate pregnancy, usually in it’s later stages. It is characterised by:

• high blood pressure
• protein in the urine (proteinurea)
• swelling (oedema)

Causes:

Current research suggests that that pre-eclampsia occurs when the placenta implants abnormally. Because the original cause is likely to be the placenta, it can affect the baby – hence the need to monitor the baby’s growth carefully – and it means that pre-eclampsia will only start to get better once the baby (actually placenta) delivers.

Treatment:

When pre-eclampsia is suspected mother and baby will need to be monitored more closely and sometimes early induction of labour is recommended. If not treated pre eclampsia can be potentially serious.

Symptoms:

Symphysis pubis dysfunction (SPD), sometimes known as pelvic girdle pain, is a condition which can occur in pregnancy which is characterised by:

• pain in the pubic bone area
• pain that is worse on walking and especially when doing activities which require temporarily resting the
• body weight on one leg such as walking up stairs or getting dressed.

Treatment:

Treatment requires referral to a specialist physiotherapist. At OBGYN Matters, when this occurs we try to make appointments with the Portland specialist physiotherapist on the same day as the appointment with Christian or Alison for your convenience.

Symptoms:

Every woman and baby have their own pattern of movements, Doctors and midwives used to advise women to use a kick chart to count to 10 movements to know that the baby is OK.

We now know, however, that it’s more important for us to know if the baby’s usual pattern of movement has changed. If that happens it’s unikely to mean there’s any problem but it is advisable you see your doctor. At OBGYN Matters we will generally suggest coming up to the Portland hospital for monitoring of the babies heart beat, to check all is well. We may also scan the baby.

We are happy to support ‘VBAC’ births, providing womens’/couples’ choice is fully informed and the baby is carefully monitored during labour. It is now widely accepted that around 70% of women who have had a previous Caesarean Section can have a vaginal birth in the next pregnancy (unless the indication for the first Caesarean remains).

We would be happy to talk through the pros and cons of VBAC for individual circumstances. See our News items for information on the low risks of VBAC.