Fetopathia diabetica is a developmental disorder in unborn or newborn children. The cause lies in inadequately treated diabetes in the mother during pregnancy. The expectant mother’s elevated blood sugar passes freely through the placenta to the fetus, causing hyperglycemia .

Untreated gestational diabetes can have serious long-term consequences for the child and the mother-to-be. There are increased disturbances in general development, growth and organ formation. If the mother-to-be suffers from diabetes, the pregnancy is automatically classified as a high- risk pregnancy . In order to prevent damage to the health of the child, close monitoring of the mother’s blood sugar is necessary throughout pregnancy.

causes

There are basically three causes for the development of fetopathia diabetica in an unborn child. In rare cases, a woman develops what is known as gestational diabetes during pregnancy. This form of diabetes only occurs during pregnancy and disappears completely after birth.

In addition, if the mother has type 1 or type 2 diabetes mellitus, there may be developmental delay in the fetus due to hyperglycemia. Glucose travels to the fetus via the placenta; the child’s circulatory system responds by increasing insulin production.

The result is fetal hyperinsulinism associated with various developmental disorders. The increased release of insulin has a stimulating effect on the synthesis of fats and proteins, which leads to enlargement (hypertrophy) of organs in the fetus.

Symptoms, Ailments & Signs

Fetopathia diabetica is often associated with premature birth . In addition, there can be placental insufficiency, which can lead to the death of the fetus before or during birth. There is also a risk of shoulder dystocia , a birth disorder in which the child’s shoulders are too large.

This makes childbirth much more difficult. Shoulder dystocia requires immediate attention as the child can die from lack of oxygen in this condition. Adjustment difficulties are very common in newborns . Affected children suffer from hypoglycemia , hypocalcemia , jaundice and shortness of breath . Furthermore, fetopathia diabetica increases the child’s risk of developing obesity later in life .

If the mother has untreated diabetes, the newborns are typically overweight and have immature organs. In severe cases, there are malformations of the internal organs. Due to the routine measurement of blood sugar as part of pregnancy examinations, severe cases of fetopathia diabetica have become rare. Affected children mostly have a normal body weight nowadays.

Diagnosis & History

The diagnosis is made during a routine examination of the pregnant woman by measuring the blood sugar level. If the disease is already more advanced, the diagnosis can also be made by sonography. In this case, an enlarged fetus, as well as anomalies of the organs, are identified by the attending physician. An enlarged liver in the unborn child in particular indicates fetopathia diabetica.

If the diagnosis is made in good time, the prognosis for children of diabetic mothers can be rated as very good. In most cases, diabetes is easily treatable and the unborn child is not harmed. After the birth, the blood sugar level of the newborn must be checked regularly in the first three hours, as glitches occasionally occur.

complications

With early and correct treatment, fetopathia diabetica can be treated relatively well, so that there are no further complications or symptoms in the child. In most cases, the disease results in premature birth. This is generally associated with severe complications, but can also be symptom-free, so that the child is born normally and healthy.

Most of the time, however, the child’s shoulders are too big. This can lead to breathing difficulties, which in the worst case can lead to a lack of oxygen. This is very dangerous, especially for newborns, and can lead to permanent damage to various organs and extremities.

As a rule, therefore, treatment of fetopathia diabetica in the child is carried out immediately. The risk of obesity in the child is also greatly increased. In most cases, there are malformations of the organs and underdevelopment of the child. The exact complications depend heavily on the mother’s diet.

An enlarged liver is common. If fetopathia diabetica is diagnosed early, most of the symptoms for the child can be eliminated during pregnancy with the help of a healthy diet. There are still no complications. In the worst case, the child can die due to shortness of breath.

When should you go to Art?

In the case of a fetopathia diabetica, treatment is necessary in any case. It does not heal itself and the disease can endanger the life of the child. As a rule, however, the disease is identified directly by a premature birth and can also be treated at an early stage. Immediate intervention is necessary if the child suffers from a lack of oxygen or from adjustment difficulties. This can lead to shortness of breath or jaundice. If no treatment occurs, the child usually dies.

Since fetopathia diabetica also significantly increases the risk of obesity in the patient’s later life, those affected must pay attention to their diet and be examined by a doctor on a regular basis. The internal organs can also be affected.

In order to avoid immature organs, parents should also take part in examinations with their child. By measuring blood sugar during pregnancy, fetopathia diabetica can also be avoided. In most cases, the disease is diagnosed and treated directly in the hospital. Early treatment can prevent further complications in adulthood.

Treatment & Therapy

The therapy serves to adjust the metabolism of the pregnant woman as optimally as possible so that there is no hyperglycaemia, which could harm the child. In order to avoid severe courses, the pregnant woman must be examined at regular intervals. Continuous monitoring of the blood sugar level is essential to ensure the success of the treatment.

If the diabetes disease is known, it is advisable to start therapy before conception. The specialist doctor can determine the severity of the diabetes and make a prognosis for the likely course of the pregnancy. In addition, the timing of the onset of pregnancy should be planned in such a way that the metabolic setting is as ideal as possible.

There are also special training courses for diabetics who want to have children, in which the participants receive information about correct nutrition during pregnancy and self-monitoring of blood sugar. In this way, it is possible to prevent damage to the unborn child. In general, the children of diabetic mothers are healthy nowadays.

Nonetheless, maternal diabetes poses a risk to the fetus, so close postpartum monitoring is essential. Treatment of the neonate for hypoglycemia is through glucose infusion. Due to the high blood sugar level in the fetus, the formation of surfactant is disturbed, as a result of which the lungs are often immature at birth. If the newborn is short of breath, artificial respiration is given or oxygen is supplied via an oxygen mask.

Outlook & Forecast

Newborns are born overweight due to fetopathia diabetica. This also poses risks for the mother during childbirth. There is a high probability that she will suffer a perineal tear or will need an episiotomy to prevent it. The liver is enlarged at birth and hypoglycemia and neonatal hypocalcemia may be present. Furthermore, fetopathia diabetica increases the risk of respiratory distress syndrome immediately after birth.

Affected newborns can also develop diabetes mellitus in the course of their lives because the body was already exposed to such high blood sugar levels at such an early stage. Severe malformations in the unborn child can already have occurred in the womb, but these are usually easy to see during the ultrasound examinations. This may allow them to be treated. If not, caregivers can anticipate any special needs of the newborn and be prepared for the deformity when the child is born.

In addition to the heart, the extremities and the urogenital tract, malformations often affect the CNS, so that damage only becomes apparent during the course of child development. There are cases of fetopathia diabetica in which the affected child was able to live almost symptom-free with appropriate treatment during and after pregnancy, in other cases the damage is severe and permanent.

prevention

Diabetics should consult a specialist before becoming pregnant. Both internists and gynecologists have the necessary specialist knowledge. In this way it can be ensured that the blood sugar level is well controlled.

All prescribed examinations should be carried out during pregnancy in order to be able to diagnose a worsening of the diabetes in good time. In this way, the development of fetopathia diabetica can be prevented.

aftercare

In the case of diabetic fetopathia, the options for follow-up care are very limited in most cases. The affected person is dependent on a purely symptomatic treatment of this disease in order to prevent further complications and to make everyday life easier for the person affected. This does not result in self-healing, although complete treatment is usually not possible.

In many cases, genetic counseling is also possible in the case of fetopathia diabetica in order to prevent the disease from being passed on to the next generation. In order to alleviate the symptoms of fetopathia diabetica permanently, those affected are dependent on regular examination and monitoring of the blood sugar level. Medical help can also be used to measure the value permanently.

In many cases, those affected are also dependent on a special diet in order to minimize the symptoms of the disease and not to burden the body unnecessarily. In the case of fetopathia diabetica, the early diagnosis of the disease is primarily important so that the child becomes healthy and can develop normally.

You can do that yourself

In everyday life, it is particularly important to ensure a healthy lifestyle throughout pregnancy. This includes a vitamin-rich and balanced diet as well as sufficient time in the fresh air. As far as possible, the mother-to-be should go for walks and do sports every day.

A pregnant woman is well advised to go to all the preventive and check-up examinations that are offered. Health problems can be identified there as early as possible and a quick response is possible. This reduces the risk of further complications. If there are any irregularities or the vague feeling that something might be wrong, the mother-to-be should also immediately seek medical help.

In addition to a healthy diet and regular monitoring, the reduction of emotional stressors also helps . An improvement in the well-being of mother and child can be achieved by exchanging ideas with other pregnant women, experienced mothers or by using relaxation methods. It is helpful to reduce fears that arise and to maintain an optimistic attitude.

If there is a high-risk pregnancy, it is particularly important that the zest for life is maintained and that contact with the social environment is maintained. A retreat or panic states have a negative impact on the further course of the pregnancy. Despite the restrictions, leisure activities can be adapted and help the pregnant woman and the unborn child to improve their health.