Elective Section with Gestational Diabetes

[oliversmummy26]

Just wondering if anyone has gone through anything similar...

My first (and only) birth ended in emergency C Section due to baby in awkward position and large (9lbs 13oz).

I have had an appointment with specialist midwife to discuss pros and cons of VBAC versus ELCS and she basically said that the choice was mine and they would support me whatever I decided.

That was at 22 weeks and I have an appointment booked with a consultant at 34 weeks to make a final decision.

However, am now 28+2 and diagnosed with gestational diabetes today. I have a clinic appointment on Thursday to get info on how to use glucose testing kit and see a dietitian etc.

Am I right in thinking now though, that as I have GD they won't want me to go over dates and so a ELCS in my case will be more likely as they won't induce a VBAC..

But does anyone know if this is likely to be earlier than the usual 39 weeks for ELCS? Or will it depend on baby's predicted size (as I understand there will be several growth scans between now and then..?

From conversations with my consultant it would likely be an ELCS unless labour occurs naturally before the booked date. My Trust doesn't like you to go over your due date. Some Trusts have a method of induction that can be used for VBAC but that isn't available in my area so I don't know the details.

Timing is likely to be based on size and health of baby and placenta. 38-39 weeks is where my consultant likes to deliver so that steroids aren't needed, but any of the above factors would lead them to deliver earlier as needed.

Do you have any preferences on the birth? Could you discuss them with the diabetes midwife or your consultant?

Hope all goes well

Thanks Duggee I would prefer ELCS to be honest, and was going to go into my consultant appointment at 34 weeks and insist on one and expecting it to be at 39 weeks.

So I'm happy that it probably means I'll be more likely to get the ELCS, I also expect this is going to be a big baby (already measuring ahead for dates on fundal height as I was with DS) and sonographer at my 12 week scan said it was incredibly unlikely that I would have a small baby...I think I just grow them big.

Lots of appointments coming up I think, so will have to see what happens but thanks for replying in the meantime..

It does sound as though this will make it easier for them to support your ELCS choice. Although, with another big baby in the offing, you'd hope there wouldn't have been any difficulty getting agreement!

Hope all goes well with your various appointments

It depends on a few factors, I was induced at 37+5 due to polyhydramnios and macrosomnia which was a direct result of GD. It also depends how your GD is treated, they may be happy to let you go up to your due date if you are diet controlled but being diagnosed so early it is very possible you will end up taking metformin and/or insulin.

Even when I was induced they didn't go so far as putting me on the drip when I didn't respond well to propess, they just went straight to section. So I think you wouldn't have a hard time persuading them that an ELCS would probably be the safest course of action for you.

Thanks haveacupoftea I had my GD clinic appointment yesterday and did ask about ELSC and was told they would do their best to leave it until 39 weeks, but it will depend on baby's size.

Obviously I've only been testing for 24 hours, but they've all been well under the 7.8 limit I've been allowed after meals so far. I'm fairly confident I will be able to control this will diet..but I do believe I'll likely have another big baby. DS was only just under the 4.5kgs, though that was at 40 +10, so may be under if delivered earlier. But they are notoriously bad at predicting baby weight, so I can imagine him estimated as large, but being delivered at 39 weeks hopefully being under 9lbs..

Just to update:
I've been testing my blood regularly now for almost two weeks, day time bloods are fine and diet is controlling them perfectly, so much so that my GD midwife is happy for me to cut down to just twice a day.
But my fasting bloods are sometimes a little high, so I've been put on 1 metformin tablet in the evening before bed.
Had a growth scan and consultant appointment yesterday, baby is measuring large on tummy and head, tummy is 95th percentile. They're not too concerned about his size, but consultant agreed very happily to ELCS at 39 weeks as I've had EMCS due to failed induction, the likelihood is that they would have to induce me early again and she was as worried as I was about history repeating itself.
So baby should be here in 9 weeks!