4
GEORGETOWN HOSPITAL SYSTEM
folic acid supplementation prior to conception in
order to reduce the risks of certain birth defects.
“Reviewing this information allows us to cover
all of the bases,” Dr. Maselli says. “Some of this
information comes up during a yearly exam, and
that is an opportunity to address any issues.”
Medications can a ect pregnancy
Many women are on medications that can cause
problems during pregnancy. Making your provider
aware of all of your medications is important.
“We discuss the patient’s current medication
regimen,” Dr. Maselli says. “Some medications can
Pre-conception
counseling is a meeting with
your health care provider
prior to pregnancy and
is intended to identify
issues that may cause
potential risks to the
pregnancy. is typically
occurs during a yearly OB-GYN checkup but is
recommended before a woman becomes pregnant.
“We counsel patients prior to pregnancy about any
areas of concern in order to reduce the risk of certain
pregnancy complications,” says Lisa R. Maselli, MD,
a Carolina OB/GYN physician. “One example is a
higher risk of gestational diabetes and C-section for
women who have a body mass index that is in the
obese category.”
Plan your pregnancy early
From a medical perspective, pre-conception
counseling refers to interventions that aim to identify
and modify medical, behavioral or social risks to
a woman’s health or pregnancy outcome through
prevention and management, Dr. Maselli says.
It is recommended that a woman visit her
physician three to six months prior to conception
so they can identify and address health issues and
plan for a healthy, safe pregnancy. Some issues that
are discussed include current medical problems
and medications; previously undetected illness or
disease; existing risks for the woman or the fetus
during pregnancy, such as being overweight; and
the importance of reducing risky behaviors such as
smoking and alcohol consumption.
“Smoking can cause preterm labor or low birth
weight,” Dr. Maselli says. “ e placenta does not
function normally under these conditions, and this
can cause these complications.”
A pre-conception visit can include body mass
index calculations, blood work, urine samples, a
blood pressure check, a medical history review and
additional screenings as recommended by your
physician. Recommendations are also made to begin
before you get pregnant
Talk to your doc
What is gestational diabetes, anyway?
Gestational diabetes is a
condition in which pregnant
women without previously
diagnosed diabetes exhibit
high blood glucose levels,
particularly in the nal
trimester.
“Gestational diabetes
and obesity can impact the outcome for both
the mother and the pregnancy,” says Carolina
OB/GYN physician Valerie A. Lasry, MD. “The
No. contributor to this disorder is obesity and
signi cant weight gain prior to pregnancy.”
Diabetes is usually classi ed into types and .
Gestational diabetes is neither of these types,
but it does increase a woman’s risk of developing
type diabetes a er pregnancy. Type diabetes is
typically caused by a combination of lifestyle factors
and genetics. Type is related primarily to genetic
factors and is usually diagnosed prior to pregnancy.
Gestational diabetes is caused when insulin
receptors do not function appropriately. It generally
has fewsymptoms and ismost commonly diagnosed
by screening during pregnancy. Complications for the
mother include postpartumhemorrhage, increased
risk of C-section, and di cult vaginal delivery with
shoulder dystocia and/or severe tearing. The
complications for the baby include lowbirthweight,
chemical imbalances and growth abnormalities.
Treatments for this condition have changed over
time. Patients used to stay on insulin. “Now, women
can manage this using Glyburide, which is an oral
medication that is milder than insulin,” Dr. Lasry
says. “For some patients, such as those who have
polycystic ovary syndrome—a hormone imbalance
that causesproblemswithmenstruation—Metformin,
another oral medication, can still be used.”
The best way to manage gestational diabetes
is through diet and exercise. Eating a healthy diet
and maintaining your weight reduces problems
associated with gestational diabetes.
“Managing the risk factors, such as diet,
for diabetes is important to ensuring a good
outcome,” Dr. Lasry says. “You start with having
a good diet with the assistance of a dietitian.
Patients and providers monitor blood sugar levels,
and if they remain normal, you continue this
regimen for the -week gestation.”
Women with gestational diabetes can deliver
a healthy baby as long as they manage their
condition well and consult consistently with their
health care provider.
Lisa R. Maselli, MD
ValerieA. Lasry,MD
impact the pregnancy, so we want to review these
and make determinations about what is safe during
the gestational period.”
With pre-conception planning and lifestyle changes,
a woman can have a safe and healthy pregnancy.
