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Question:

From British Columbia, Canada:

My wife (35) has been diagnosed with Type 1 diabetes for the past 3 years. She also has mitral valve prolapse [a heart condition] which is not causing any difficulty or symptoms at this stage. Would a pregnancy be desirable given the aforementioned?

Answer:

Probably one of the most significant factors contributing to successful pregnancy outcome is preconceptual glucose control. Basically the closer that fasting and postprandial blood sugar values are to normal (I use less than 105 mg/dl fasting, and less than 130 mg/dl at 1 hour postprandial as guidelines) the greater the likelihood that the risk of congenital abnormalities will be minimized. However, do not drive yourself crazy over an occasional elevated blood glucose value. As a global view of glucose control, it will be worthwhile measuring a hemoglobin A1C value. If this is in the normal range during the preconceptual period, there is also a reduced risk of effects on the fetus.

During pregnancy the same blood glucose values are followed. This is especially critical during the embryonic period (conception to 9 weeks gestation). But is also important throughout pregnancy to prevent excessive growth of the fetus.

The fact that your wife has had diabetes for a brief period of time places you in a relatively low risk group for pregnancy complication.

Mitral valve prolapse is common in women and should not represent any major risk to a pregnancy.

OWJ

Original posting 14 Apr 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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