Poor glycemic control during the later stages of pregnancy increases the rate of fetal macrosomia, defined as a birth weight of more than 4000 g. The macrosomic fetus of the diabetic mother tends to have a disproportionate increase in shoulder, trunk, and chest size, leading to risk of shoulder dystocia. Failure of fetal descent or labor progress leads to difficult vaginal birth. A vaginal birth may lead to birth injuries in the infant, such as facial nerve injury. Ketoacidosis is a result of uncontrolled glycemia, which affects the mother during pregnancy. Hypoglycemia, not hyperglycemia, is a risk for infants born to diabetic mothers. In the later stages of pregnancy, hypoglycemia may occur as insulin doses are adjusted to maintain a normal blood glucose level. (B,C,D) How does diabetes during pregnancy affect a fetus?If your blood sugar level is higher than the standard range, it can cause your baby to grow too large. Very large babies — those who weigh 9 pounds or more — are more likely to become wedged in the birth canal, have birth injuries or need a C-section birth. Early (preterm) birth.
What are fetal complications from maternal diabetes that the nurse must monitor for?Fetal complications include preterm labor and delivery, small or large size for gestational age, shoulder dystocia birth injury, and neonatal hypoglycemia.
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Diabetes in pregnancy puts the fetus at risk in several ways. what should nurses be aware of?
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