Third Trimester! (and GDM)

I'm happy to announce that we have officially entered the third trimester!

Along with this wonderful news, we received an email from SCI last week informing us of an extra scan per the obstetrician's advice.  When I read this, it did worry me that there was medical concern enough to warrant more scrutiny just a week after our 3D scan.

Greetings from SCI Healthcare..!!!

We hope you are doing well.

We would like to inform you that as per our obstetrician's advise we have done extra USG scan for Meera.

Kindly find attached herewith reports of the same.

We are happy to inform you that our obstetrician has reviewed the reports & noted everything fine.

Your surrogate mother is doing fine.

As per our obstetrician's advise your baby is also doing fine.

Please note that her next scan will be done within one month.

We will keep you updated with her further progress & new status.

 

With Best Regards,

Yogita

SCI Healthcare

OK, so everything was fine?  Yeah!  


Not so fast.  


Within the hour, another email was received:

Greetings from SCI Healthcare !!

We hope you are doing fine.

We would like to inform you that as a part of our routine test, we have detected mild diabetes in your surrogate mother Meera.

Please note that she has been reviewed by the Specialist Physician and has been started on 8 units of insulin daily after breakfast.

We are keeping a close eye on her blood sugar level and also on the pregnancy.

We will keep you updated with her progress & new status.

With Best Regards,

Lalit

SCI Healthcare

OK, gestational diabetes mellitus (GDM), I've heard, is not uncommon.  And SCI said it was "mild."  This is what I read from Diabetes.org:

Pregnant women who have never had diabetes before but who have high blood glucose (sugar) levels during pregnancy are said to have gestational diabetes....it is estimated that gestational diabetes affects 18% of pregnancies.

We don't know what causes gestational diabetes, but we have some clues. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother's insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother's body to use insulin. She may need up to three times as much insulin.

However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby's pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.

This can lead to macrosomia, or a "fat" baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby's pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.

OK, this last part really scared us, so I emailed Dr. Shivani about the treatment and she responded with the following:

She is on 8 units Insulin -- titration of the dose is done as per the daily blood sugar readings which are done two to three times in a day.

The CTG recordings are also done regularly for the baby's heart beat.

With diabetes baby's tend to be large for dates and this could be why baby is measuring a bit big -- also scan is not the most accurate so lets wait and see how things go.

This is called gestational diabetes -- related to pregnancy -- the requirements of insulin could go up and down and generally once pregnancy is over the diabetes will resolve - we will need to monitor her sugars till it does post delivery.

Best wishes

Dr Shivani

At least Meera was being treated, and we can only hope that it prevents any of the serious complications to the baby from gestational diabetes.  We are also hopeful that Meera will be fine after delivery.  I think she must be wondering "what did I get myself into?"  All kidding aside, we will be eternally grateful for her role in creating our little one, despite the challenges.

So for now, the celebrations are postponed and the planning is in full swing for what we have dubbed "Operation Baby Pick-up."