Fetopathia diabetica is a serious developmental disorder that occurs in unborn or newborn children and is caused by excessive blood glucose levels in the mother. The treatment consists mainly of an ideal metabolic adjustment of the pregnant woman. If this is successful, fetopathia diabetica and the associated risks for the child can be largely prevented.
What is fetopathia diabetica?
Fetopathia diabetica is a developmental disorder of unborn or newborn children. It is caused by inadequately treated diabetes in the mother during pregnancy. The mother’s elevated blood sugar passes unhindered through the placenta to the fetus and leads to hyperglycemia. Untreated gestational diabetes can be associated with serious late effects for the child and the expectant mother. There are increased disturbances in general development, growth and organ formation. If the expectant mother suffers from diabetes, the pregnancy is automatically classified as a high-risk pregnancy. To prevent damage to the child’s health, close monitoring of the mother’s blood glucose is necessary throughout the pregnancy.
Causes
Basically, there are three causes for the development of fetopathia diabetica in an unborn child. In rare cases, the woman develops what is known as gestational diabetes during pregnancy. This form of diabetes exists only during pregnancy and completely regresses after birth. In addition, the development of the fetus may be impaired due to hyperglycemia if the mother has diabetes mellitus type 1 or type 2. Glucose reaches the fetus via the placenta; the child’s circulatory system responds by increasing insulin production. The result is fetal hyperinsulinism, which is associated with various developmental disorders. The increased secretion of insulin has a stimulating effect on the synthesis of fats and proteins, resulting in the enlargement (hypertrophy) of organs in the fetus.
Symptoms, complaints, and signs
Fetopathia diabetica is often associated with premature birth. In addition, placental insufficiency may occur, which can lead to fetal death before or during delivery. There is also a risk of shoulder dystocia, a disorder of the birth process in which the child’s shoulders are too large. This makes the birth much more difficult. Shoulder dystocia requires immediate action, as the child may die from lack of oxygen in this condition. Very often, newborns experience adjustment difficulties. Affected infants suffer from hypoglycemia, hypocalcemia, jaundice, and respiratory distress. Furthermore, fetopathia diabetica increases the child’s risk of obesity later in life. If the mother’s diabetes is untreated, the newborns are typically overweight and have immature organs. In severe cases, malformations of the internal organs occur. Due to routine measurement of blood glucose as part of prenatal examinations, severe cases of fetopathia diabetica have become rare. In most cases, affected children nowadays have a normal body weight.
Diagnosis and course
Diagnosis is made during a routine examination of the pregnant woman by measuring blood glucose levels. If the disease is already more advanced, the diagnosis can also be made sonographically. In this case, an enlarged fetus and abnormalities of the organs are detected by the attending physician. In particular, an enlarged liver of the unborn child indicates fetopathia diabetica. If the diagnosis is made in time, the prognosis of children born to diabetic mothers is considered to be very good. Diabetes is easily treatable in most cases and the unborn child is not harmed. After birth, the newborn’s blood glucose level must be monitored regularly for the first three hours, as derailments occasionally occur.
Complications
If treated early and properly, fetopathia diabetica can be treated relatively well, resulting in no further complications or discomfort in the child. In most cases, the disease causes premature birth.This is generally associated with severe complications, but can also be without symptoms, so that the child is born ordinary and healthy. Most often, however, the child’s shoulders are too large. This can cause breathing problems, which in the worst case can lead to oxygen deficiency. This is very dangerous, especially in newborns, and can lead to permanent damage to various organs and extremities. Therefore, as a rule, treatment of fetopathia diabetica in the child is carried out immediately. Similarly, the risk of obesity in the child is greatly increased. Most often there are malformations of organs and underdevelopment of the child. The exact complications depend largely on the mother’s diet. There is often an enlarged liver. 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 will still be no complications. In the worst case, the child may die due to respiratory distress.
When should you go to the Art?
In any case of fetopathia diabetica, treatment is necessary. There is no self-healing and the disease can endanger the life of the child. However, the disease is usually identified directly by premature birth and can also be treated early. Immediate intervention is necessary if the child suffers from oxygen deficiency or adaptation difficulties. This may result in respiratory distress or jaundice. If no treatment occurs, the child usually dies. Since fetopathia diabetica also significantly increases the risk of obesity later in the patient’s life, those affected must watch their diet and have regular checkups with a doctor. Internal organs may also be affected. To avoid immature organs, parents should also participate in examinations with their child. Fetopathia diabetica can also be prevented by measuring blood sugar during pregnancy. In most cases, the diagnosis and treatment of the disease is carried out directly in the hospital. Early treatment can prevent further complications in adulthood.
Treatment and therapy
Therapy is used to adjust the metabolism of the pregnant woman as optimally as possible so that there is no hyperglycemia, which could harm the child. To avoid severe courses, the pregnant woman must be examined at regular intervals. Continuous monitoring of the blood glucose level is essential to ensure the success of the treatment. If the diabetes is known, it is recommended to start the therapy before conception. The specialist can determine the severity of the diabetes and give a prognosis for the probable course of the pregnancy. In addition, the timing of the onset of pregnancy should be planned so that metabolic control is as ideal as possible. There are also special training courses for diabetics who wish to have children, in which participants receive information on proper nutrition during pregnancy as well as self-monitoring of blood glucose. This helps to prevent damage to the unborn child. In general, the children of diabetic mothers are healthy nowadays. Nevertheless, the mother’s diabetes poses a risk to the fetus, which is why intensive monitoring after birth is absolutely necessary. Treatment of the newborn in hypoglycemia is done by glucose infusion. The excessively high blood glucose level in the fetus disrupts the formation of surfacant, which often causes the lungs to be immature at birth. If the newborn suffers from respiratory distress, artificial respiration or oxygen is administered via an oxygen mask.
Outlook and prognosis
Newborns are born overweight because of fetopathia diabetica. This also poses risks to the mother during delivery. She is very likely to suffer an episiotomy, or an episiotomy must be placed to prevent it. At birth, the liver is enlarged and there may be hypoglycemia as well as hypocalcemia in the newborn. 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 exposed to such high blood glucose levels at such an early stage. Severe malformations of the unborn child may already have occurred in the womb, but these are usually easy to see during ultrasound examinations. This may allow them to be treated. If not, the nursing staff can adjust to possible special needs of the newborn and be prepared for the malformation when the child is born. However, malformations often affect the CNS in addition to the heart, extremities, and genitourinary tract, so damage does not become apparent until the child develops. 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, damage is severe and permanent.
Prevention
Diabetic women should see a specialist even before they become pregnant. Both internists and gynecologists have the necessary expertise. This can ensure that blood glucose levels are well controlled. During pregnancy, all prescribed examinations should be attended in order to be able to diagnose a worsening of the diabetes in time. In this way, the development of fetopathia diabetica can be prevented.
Follow-up
In most cases of fetopathia diabetica, the options for follow-up care are very limited. In this case, the affected person is dependent on a purely symptomatic treatment of this disease to prevent further complications and to facilitate the daily life of the affected person. This does not result in self-healing, and complete treatment is usually not possible either. In many cases of fetopathia diabetica, genetic counseling is also possible to prevent the disease from being inherited by the next generations. In order to permanently alleviate the symptoms of fetopathia diabetica, those affected depend on regular examination and control of blood glucose levels. This may also involve the use of a medical aid to measure the level on a permanent basis. In many cases, sufferers also rely on a special diet to minimize the discomfort of the disease and avoid putting unnecessary stress on the body. In the case of fetopathia diabetica, early diagnosis of the disease is also important in the first place, so that the child can get healthy and develop usually.
This is what you can do yourself
In everyday life, particular attention should be paid to a healthy lifestyle throughout pregnancy. This includes a diet rich in vitamins and balanced, as well as sufficient stays in fresh air. As far as possible, the expectant mother should engage in daily walks and sports activities. A pregnant woman is well advised to go to all the preventive and check-up examinations offered. There, health problems can be detected as early as possible and a quick response is possible. This reduces the risk of further complications. In case of irregularities or the diffuse feeling that something might be wrong, the expectant mother should also seek medical support immediately. In addition, besides a healthy diet and regular checkups, reducing emotional stressors helps. By talking to other pregnant women, experienced mothers or using relaxation techniques, an improvement in the well-being of mother and child can be achieved. It is helpful to reduce emerging fears and to maintain an optimistic basic attitude. If there is a high-risk pregnancy, it is particularly important to maintain a zest for life and to continue to maintain contact with the social environment. Withdrawal or panic states have a negative influence on the further course of pregnancy. Leisure activities can be adapted despite the restrictions and help the pregnant woman and the unborn child to better health.
