I “failed” my glucose test…

You drank that not so wonderful orange (or maybe you go lemon-lime?) drink and got a call the next day.  You “failed”.  What does that mean and what happens now?

During pregnancy the placenta starts releasing a hormone that makes women insulin resistant.  Most of the time the body can still maintain blood sugars in a normal range, but approximately 6% of the time is pushes women over into diabetes. The insulin resistance is typically temporary and resolves after the placenta is delivered.

It is important not to miss the diagnosis of gestational diabetes as there is increased risk to both mom and baby.  Moms have an increased risk of blood pressure problems, preeclampsia or toxemia of pregnancy and long term are at higher risk of type 2 diabetes.  The fetus is at risk of growth problems, birth trauma such as shoulder dystocia, bone fracture and nerve palsy, as well as higher chance of still birth.  Scary as all of these issues are, they are largely avoidable if diabetes is diagnosed and well controlled.

So that we don’t miss anyone that might have gestational diabetes, the first orange drink test “failure” is set at a low enough level that it will catch everyone that has it.  The problem with the low cut-off is that it also catches a lot of people that do NOT have diabetes.  This is what we define as a screening test. So the next step is the diagnostic test to weed out the “false positive” results.  We do this through a longer, 3 hour test.  I will be honest- it is not a fun test.  Our office will give you instructions to carb load for a few days prior to the test.  This sounds counter-intuitive because we just told you your body may not be able to process carbs and now we want you to to eat extra carbs.  The reason behind this is that this gives the pancreas the best chance to prepare for the extra sugar load of the second drink.  The day of the actual test you will come to the lab fasting and get a blood test, drink another lovely orange drink, then get a blood sugar test every hour for 3 hours.  It’s long.  It’s boring.  You are pregnant and hungry.  So again- we know it’s not a fun test, but it is really important.

No one wants gestational diabetes.  But with appropriate testing and treatment we can work together to make sure that at the end of  the pregnancy you have a healthy baby and a healthy mama.

In the age of smart phones and Google, it’s no surprise to me that my patients walk into our office with a wealth of information.  Search “pregnancy” on the iPhone App Store and you’ll get hundreds of results.  We’ve taken the time to review some of the available pregnancy apps and here are some of my favorites (and the best news is that they are all free!).

1. Period Tracker

Whether you’re planning for a pregnancy or trying to track your irregular bleeding patterns, Period Tracker keeps track of it all.  It tracks your period and ovulation cycles every month and is very easy to use.  It keeps track of your menstrual interval (the time from the start of one period to the start of the other) and predicts when you should get your next period.  This can be helpful for vacation planning too!

2. Sprout

Like many of the other pregnancy apps, Sprout customizes to your pregnancy after you input your due date.  It is unique in that it offers amazing 3D images of how the baby is developing from week to week.  Included in this app is a contraction timer, weight tracker, and baby kick counter.

3. My Pregnancy Today

This is a newer app which is gaining popularity quickly.  It offers suggestions for how to keep yourself in the best possible health during a pregnancy in addition to images of the developing baby, what to expect in the weeks to come, and a due date calculator.

4. Contraction Monitor

In the midst of wondering “am I in labor?” this app is here to help keep track of contractions.  Not only does it keep track of contraction frequency like many of the contraction apps, it allows mom to rate the intensity of the contraction and keeps track of how long contractions are lasting.  This is very helpful information to provide to your health care provider when you think you’re in labor.

5. Baby Names

This app offers thousands of ideas for naming your baby.  If you’ve waited until delivery to start thinking of about a name, this offers lots of ideas in the palm of your hand.  It’s also a fun app to keep you busy when you’re waiting in line.

*It’s important to know that most apps are created for fun and are not approved by medical professionals.  If you have questions or concerns based on the information you’re reading online or on an app, be sure to discuss it with your health care provider.

In the third trimester of pregnancy, all  women will notice the onset of daily hiccups from their babies in utero.  Why is this?  Is it normal?

It is perfectly normal and reassuring of a normally developing nervous system.  The nervous system begins to mature in a fetus around 26 weeks gestation and , as a result, a series of reflexes begin to become apparent in the growing baby by 32 weeks.  The term hiccup (or hiccough) originates from the Latin meaning “to gasp”.  Hiccups are actually a reflex caused by involuntary contractions of the diaphragm and rib muscles that result in a sudden inspiration and closure of the glottis (AKA “voice box”).   These reflexes, hiccups included, persist through the third trimester and generally disappear when the baby is around 3 months of age.

When a fetus has a hiccup, the muscles involved with breathing contract and it is suspected that this exercises the breathing muscles before the baby is born.    As the nervous system is maturing, a fetus will have several episodes of hiccups every day.

So, next time your feel those sudden intermittent little spasms in your uterus in the third trimester, be reassured that your baby is maturing normally and exercising the little breathing muscles in preparation for taking his or her first breath in the first moments of life.