Question regarding inducing because of GD.

sarakiefer

Why is it the norm to be induced at 39 weeks if you have GD?  When I was diagnosed at 26 weeks, my OBs told me that they would be inducing me at 39 weeks.  I figured it was because he could potentially be a big baby and that it would do more harm than good to keep him in til 40 weeks. 

Well, I'll be 39 weeks the day after Thanksgiving.  My OB informed me that I will more than likely not be able to be induced that day because they only do inductions at the hospital I want to deliver at on Thursdays.  If I waited until that Thursday, Dec 1st, when I'm due the 2nd, why was it so important to make sure I was induced at 39 weeks in the beginning?  LO currently weighs 7lbs 8oz and is in the 83rd percentile, so I'm looking at a big baby already.  Is it all of a sudden not important anymore because I don't fit into their schedule??

memali26

It not so much inducing at exactly 39 weeks (because due dates are just an estimate any) it's more about not going overdue. In diabetics (GD or otherwise, to my understanding) the placenta can age more rapidly than usual, which can cause the baby to not get the nutrients they need. Going overdue increases the risk of the placenta deteriorating in a "normal" pregnancy, but it's a slightly higher risk in a GD pregnancy. So, to avoid that and the slightly increased possibility of still birth because of it, many doctors will induce GD moms a little early, though usually not before 39 weeks. A few days past 39 isn't typically an issue - my first GD baby was born at 39w 2d, my second at 39w exactly. Both inductions began at 38w 6d.

MotherMonster

It's not a slight risk of it maturing faster. It's a fact. I'm sure they'll measure your placenta and check it out on ultrasound to make sure you're good! If they aren't going to do that, I'd make sure they do! 

kristin172429

Induction is a standard of care for a lot of docs regarding GD.  It is not always necessary and can be decided on a case-by-case basis.  Some docs do it because of a possibly large baby, others do it because of possible placenta deterioration (this happens more with Type 1&2 diabetics - it is not as likely with GD).  Essentially, it sounds like you doctor follows a 39 week induction standard as practice, but doesn't stick to it unless the risk is high.  

Are you getting regular u/s or NSTs?  If you and baby and your placenta are all fine, then they probably aren't stressed about waiting (otherwise they would induce you earlier instead of later if they can't "fit you in").   

sarakiefer

kristin172429:

Induction is a standard of care for a lot of docs regarding GD.  It is not always necessary and can be decided on a case-by-case basis.  Some docs do it because of a possibly large baby, others do it because of possible placenta deterioration (this happens more with Type 1&2 diabetics - it is not as likely with GD).  Essentially, it sounds like you doctor follows a 39 week induction standard as practice, but doesn't stick to it unless the risk is high.  

Are you getting regular u/s or NSTs?  If you and baby and your placenta are all fine, then they probably aren't stressed about waiting (otherwise they would induce you earlier instead of later if they can't "fit you in").   

Yes I've been going in twice a week.  Every Tuesday I get a BPP and every Thursday I get an NST.  LO has passed everything so far and looks to be perfectly healthy.  He's just big!  I've been keeping good track of my sugar numbers and I'm not on any medication, so this may be why my OB isn't stressed about it.  In fact, he had even said if I were to be induced, it would be considered elective.  I didn't understand that when he said it.  But this explanation you gave helps!  Thank you!

memali26

MotherMonster:

It's not a slight risk of it maturing faster. It's a fact. I'm sure they'll measure your placenta and check it out on ultrasound to make sure you're good! If they aren't going to do that, I'd make sure they do! 

Yes, it's a fact that diabetes can cause the placenta to age faster, but it doesn't happen to everyone - hence my saying it's a risk. 

DBride2006

With DS my GD induction was scheduled for 2 days after my due date, but I was having regular NSTs since I was on insulin. So, the 39 week rule is not hard and fast. I'm sure you'll be fine waiting as long as you are being monitored!

chicsub

Also, some docs will just group all types of GD patients together whether they are on insulin or well-controlled with diet alone.  I was allowed to go to 42w, but had DD at 40w1d on my own, so that deadline was moot.  I was doing weekly NSTs starting at 35w though and would have done BPPs after my EDD.  Honestly, it's b/c a lot of practitioners just fall back on old data and are super conservative vs. keeping up-to-date on current medical literature on the subject.  Were you on insulin right away when you got the dx or did your doc just jump to induction talk immediately based solely on a GD dx?  Sounds like things are going great so far, so I wouldn't worry too much about a couple days if things continue that way.  GL!