What are the Complications of Gestational Diabetes?

Well, first of all we can run through some of the potential complications that could develop from GDM. In a case of poorly controlled gestational diabetes it is common for the baby to be larger (macrosomic), and as mentioned earlier this can pose a problem when it comes to delivery.

Interestingly in some cases the muscle that separates the right side of the fetal heart from the left side of the heart can become much thicker, and this could affect blood flow through the cardiac valves of the baby’s heart.

Also as mentioned earlier, if the placenta becomes bigger, it can grow upwards and out of the way, but it has the potential to also extend downwards and into the lower segment of the uterus. If the placenta extends into the lowest segment of the uterus after 26 weeks, we call that a placenta previa, or a low lying placenta. This can be linked with episodes of unexpected and sometimes heavy bleeding. This can sometimes be heavy enough to warrant premature delivery of the baby.

I mentioned that the fluid around the baby increases the chances that the baby can adopt a malposition, that is being in a position other than being head down, which of course would then mean that there will be a greater need for a cesarean section delivery.

More than this, for the reasons already mentioned, a patient with diabetes can have a very big tummy which increases her chances of coming into premature labor or developing premature rupture of the membranes.

Finally, the strange thing is that when a woman has poorly controlled gestational diabetes, there is a link with a delay or an inadequate production of a special chemical that is involved in helping the lungs mature (surfactant). So these babies might be born prematurely, but they are born with immature lungs. Thus, a baby born to someone with gestational diabetes at any particular gestational age can behave poorly with regards to respiratory function compared to a baby born at the same age to a woman who did not have gestational diabetes.

There are a number of problems related to gestational diabetes beyond those that I have mentioned and these also include problems of placental function.