OBSTETRIC CONDITIONS
Premature Rupture of Membranes ( PROM )
Premature rupture of the membranes ( PROM ) involves rupture of the amniotic sac or “ bag of water ,” prior to the onset of labor . It is thought to be related to infection , but in many cases we cannot determine the exact cause . If you experience a large gush of fluid from your vagina at any time during pregnancy , call the MEU immediately at 205-975-6105 .
If you are uncertain whether your water has broken , clean off and put on dry clothing . If these clothes rapidly become wet due to constant leaking , your membranes are most likely ruptured . Management of PROM depends upon the gestational age at the time of rupture . In all cases , we recommend that you come to the Maternity Evaluation Unit ( 1700 6th Avenue South , UAB Women and Infants Center , 3rd floor ) for evaluation .
Multiple Pregnancies
Multiple gestation refers to pregnancies involving more than one baby . Nearly all multiple gestations are diagnosed early in pregnancy by ultrasound . Due to risk of premature delivery and preeclampsia , this condition requires more intense prenatal care .
Diabetes
Diabetes mellitus is the most common medical complication of pregnancy . Diabetes mellitus in the mother , if not carefully controlled , may cause complications for the unborn baby . It is important to distinguish two major categories of diabetes mellitus in pregnancy .
• Gestational Diabetes – Gestational diabetes is a diagnosis restricted to women whose bodies cannot handle glucose normally during pregnancy . About 90 % of cases of diabetes that complicate pregnancy are of this type . Most cases of gestational diabetes mellitus are controlled by diet . After a diabetic diet begins , blood sugars are monitored during the pregnancy . Some patients whose blood sugars remain elevated with dietary control may require insulin . We test all pregnant women at 24-28 weeks of pregnancy for gestational diabetes mellitus , and we may also screen you at your first visit if we identify certain risk factors for diabetes . Gestational diabetes usually resolves after delivery . Women who have problems with glucose control in pregnancy are at higher risk of developing diabetes mellitus in the future . For an expectant mother whose diabetes during pregnancy has been well-controlled by diet alone , the prognosis is excellent .
• Pre-existing Diabetes – Patients who have diabetes that existed prior to pregnancy are at risk for serious complications of pregnancy . Major congenital birth defects are increased in infants of women with pregestational diabetes mellitus . The increased incidence of birth defects is related to poor glucose control . Poor glucose control , prior to conception and in early pregnancy , is also associated with miscarriage . Appropriate glucose control prior to conception and throughout pregnancy is recommended .
72 My Prenatal Care Book