Conditions such as diabetes, thyroid disease, and blood clotting disorders (known as thrombophilias) are of special concern while you are pregnant because of the risk they pose to you and your baby. While most women with these types of conditions have uneventful pregnancies and healthy babies, they do require special monitoring and, in some cases, treatment during pregnancy:

Diabetes During Pregnancy

If you are diabetic and become pregnant, your health and that of your baby can be at risk. The risk of having problems during your pregnancy is greatest when your blood sugar levels are too high. By controlling your blood sugar levels during your pregnancy, you can reduce the risk of:

• Macrosomia occurs when your blood sugar level is high throughout pregnancy. This allows too much sugar to go to your baby and can cause the baby to grow too large, making delivery difficult.
• Preeclampsia is high blood pressure during pregnancy. This can pose severe health problems for you and your baby and may require your baby to be delivered early.
• Polyhydramnios occurs when there is too much amniotic fluid in the sac that surrounds the baby. This can result in preterm labor and delivery.
• Urinary tract infections can occur without symptoms. If the infection is not treated, it may spread from the bladder to your kidneys.
• Respiratory distress syndrome can make it harder for your baby to breathe after birth.
• Stillbirth delivery of a baby that has died before birth - occurs more often in babies of women whose diabetes was not well controlled during pregnancy.

Your doctor will closely monitor you during your pregnancy. Regular screening tests will be used to ensure early detection of any problems you or your baby may be having. You can also take the following steps to manage your diabetes during your pregnancy:

• Eat a balanced diet consisting of several small meals and snacks throughout the day.
• See your doctor regularly for checkups and tests.
• Follow a moderate exercise program as prescribed by your doctor.
• Check your glucose often each day to keep it at a normal level.
• Take insulin injections or pills as prescribed by your doctor.

In most cases, women with diabetes go into labor normally when the time comes and have a normal vaginal delivery. They may require special monitoring of their glucose levels and the baby during labor. If there are problems during pregnancy, labor may need to be induced early.

After birth, most babies do well. Some babies may need to spend time in a special care nursery. Problems that may occur include:

• Low glucose levels
• Low blood calcium and magnesium levels
• An excess of red blood cells
• Neonatal jaundice (yellow discoloration of the skin)
• Breathing problems.

These problems are not serious in most cases and are all treated fairly easily soon after birth. If your blood sugar levels are well controlled during pregnancy, your baby is less likely to have problems after birth. Women with diabetes can breastfeed their babies in most cases.