News about inducing babies early to prevent stillbirth

[Margi1975]

I’ve just read an article about this in the news page, but can’t seem to link it to a comment on the forum, but basically the title here says it all. I hope the comment below, that I wrote on the news page first, but couldn’t post, makes sense. They are calling the knowledge of needing to induce births early to prevent the risk of stillbirth a new discovery, but...

I’m confused by this being called newly discovered information. My first baby was induced two weeks early, nearly 35 years ago, for this very reason. I was on my third baby with the same demand from the doctors when I finally bullied them into telling me why (I refused to leave the room until the doctor gave me the real reason why they needed to induce diabetic mums early). He really didn’t want to tell me but he had to, and he said that sometimes the baby can die if left to full term. I was happy with his answer and said, ‘Fine. Go ahead then.’ But they knew this at least 35 years ago and are now calling it a new discovery. I hear things like this so often. ‘New’ discoveries seem to happen for the same things at least once every generation I’m sure. What happens to the knowledge that used to be there?

 

[HSSS]

I just saw a bbc report in apple news that said type one 3 times more likely to have a stillbirth mostly influenced by pregnancy bgl’s. Shockingly, type two 4 times more likely and influenced more by pre conception levels. Sadly the page refreshed before I could go back and look at links and details and I can’t find it at all now. I didn’t see details about how relevant treatment regimes were or what sort of control levels are being referred to and that is extremely relevant. Without doubt good treatment and good control makes a world of difference.

The difference you refer to is probably official study results as opposed to well known knowledge not yet supported by published papers

Links can only be posted once you’ve got a few posts under your belt on the forum to prevent spam.

 

[HSSS]

Ah this would be the link

https://www.diabetes.co.uk/forum/th...-to-lower-stillbirth-risk-in-diabetes.166886/

And importantly here it lists absolute risk, not relative, and it’s in the 1% and 2% range of all pregnancies in those groups which is nowhere near as scary as 3 and 4 times the risk sounds. It makes a difference how it’s reported!

 

[EllieM]

You've got to wonder whether the higher risk for T2 mums has something to do with the fact that T2s are encouraged not to do blood sugar testings.... I presume that rule goes by the wayside once pregnancy is confirmed.

62 (ish, not sure of the exact date) years ago my eldest sister was stillborn (according to my T1 mother, who woke from her caesarean to be told this, plus the fact that the baby was born with spina bifida so severe that she could not survive the birth). My father reckons that the baby was born live, because he had to register a birth certificate, but either way the child was dead before my mother came round from the anaesthetic. (He never told my mother this, as he did not think it would help her.) She was told that this was because she became pregnant too soon after her extremely late T1 diagnosis. (There were a lot of extremely embarrassed doctors in our family who feel that they should have noticed her T1 induced weight loss.)

Modern medical treatment is a wonderful thing. Plus remember 100 years ago T1 was an automatic death sentence.

 

[DCUKMod]

You've got to wonder whether the higher risk for T2 mums has something to do with the fact that T2s are encouraged not to do blood sugar testings.... I presume that rule goes by the wayside once pregnancy is confirmed.

62 (ish, not sure of the exact date) years ago my eldest sister was stillborn (according to my T1 mother, who woke from her caesarean to be told this, plus the fact that the baby was born with spina bifida so severe that she could not survive the birth). My father reckons that the baby was born live, because he had to register a birth certificate, but either way the child was dead before my mother came round from the anaesthetic. (He never told my mother this, as he did not think it would help her.) She was told that this was because she became pregnant too soon after her extremely late T1 diagnosis. (There were a lot of extremely embarrassed doctors in our family who feel that they should have noticed her T1 induced weight loss.)

Modern medical treatment is a wonderful thing. Plus remember 100 years ago T1 was an automatic death sentence.

EllieM - I don't want to deflect this thread from the OP, but I'd tend to agreee with others that it'smlikely there is a greater understanding of likelyhoods and probablilities these days.

On the subject of T2s, I sort of wonder how many of these "T2 mums" are actually diagnosed T2 when to trundle along to their Doc to confirm their pregnancies. Purely anecdotally, I seem to observe younger folks seem to have some very high A1cs on diagnosis, whereas those more mature have more of a range of diagnostic ranges. I'm not actually sure at which point a T2 diagnoses would be considered a gestational diabetes diagnosis, bearing in myind the historic picture "drawn" by the A1c.

Again, I stress those are my feelings from observations, as opposed to being informed by research.

Sorry to ramble on @Margi1975 .

 

[NicoleC1971]

I am 11 + years on from my last of 3 pregnancies and do remember the trepidation on the faces of older midwives who can recall times when type 1 mothers suffered still births and the GP who burst my pregnancy joy by saying that she was sorry but there was a big chance of something going wrong... I have 3 healthy children but I think 2 of them would not have survived without early delivery through c sections. We are more likely to have pre eclampsia and to have big babies that are problematic to deliver. On the plus side if you are a known risk then in the UK at least you are likely to be well monitored with frequent heart rate tracings to check all's well and be aware of the added risk; when I felt my baby stop moving at 34 weeks I knew he needed to be delivered and the consultant agreed.
Type 2 ladies are likely to be larger and possibly older which further raises their obstetric risk on top of the risk of having a large 'marcosomic'? baby so I am speculating that this is the reason for the added risk.

 

[EllieM]

I am 11 + years on from my last of 3 pregnancies and do remember the trepidation on the faces of older midwives who can recall times when type 1 mothers suffered still births and the GP who burst my pregnancy joy by saying that she was sorry but there was a big chance of something going wrong...

Wow, my youngest is 24 and I never had any suggestion that my diabetes doomed my pregnancy.
Having said that, induction at 38 weeks was assumed (and after my failed induction for my first child the caesarean at 38 weeks for my second was automatic). And the technology had advanced by my second so there was an iffy ultra sound at 25 (+- 5) weeks, where the consultants stated that they needed to do another at birth to see whether my daughter's heart was OK. A couple of days after her birth we went for the ultrasound and after much incomprehensible discussion between the consulting doctors I was told she was fine. The nurse who accompanied me told me that she was worried too (before the final verdict). And she's never had any heart issues since birth so I assume she is OK now....

 

[wiflib]

...and they never tell you of the horrors and risks directly associated with induction of labour...

 

[Robinredbreast]

I am 11 + years on from my last of 3 pregnancies and do remember the trepidation on the faces of older midwives who can recall times when type 1 mothers suffered still births and the GP who burst my pregnancy joy by saying that she was sorry but there was a big chance of something going wrong... I have 3 healthy children but I think 2 of them would not have survived without early delivery through c sections. We are more likely to have pre eclampsia and to have big babies that are problematic to deliver. On the plus side if you are a known risk then in the UK at least you are likely to be well monitored with frequent heart rate tracings to check all's well and be aware of the added risk; when I felt my baby stop moving at 34 weeks I knew he needed to be delivered and the consultant agreed.
Type 2 ladies are likely to be larger and possibly older which further raises their obstetric risk on top of the risk of having a large 'marcosomic'? baby so I am speculating that this is the reason for the added risk.

I had a smallish baby at 33 weeks, I was admitted to hospital with HELLP syndrome, a more rare condition and the emergency C section and platelets transfusion saved both our lives. I was 42 1/2 years old, but was told it wasn't due to diabetes, it was just one of those things and it happened overnight, one day after I started maternity leave.

 

[NicoleC1971]

I had a smallish baby at 33 weeks, I was admitted to hospital with HELLP syndrome, a more rare condition and the emergency C section and platelets transfusion saved both our lives. I was 42 1/2 years old, but was told it wasn't due to diabetes, it was just one of those things and it happened overnight, one day after I started maternity leave.

Hi. I still miss that sofa time I was looking forward too as my baby got delivered before my leave even started. Boo hoo!

 

[NicoleC1971]

Wow, my youngest is 24 and I never had any suggestion that my diabetes doomed my pregnancy.
Having said that, induction at 38 weeks was assumed (and after my failed induction for my first child the caesarean at 38 weeks for my second was automatic). And the technology had advanced by my second so there was an iffy ultra sound at 25 (+- 5) weeks, where the consultants stated that they needed to do another at birth to see whether my daughter's heart was OK. A couple of days after her birth we went for the ultrasound and after much incomprehensible discussion between the consulting doctors I was told she was fine. The nurse who accompanied me told me that she was worried too (before the final verdict). And she's never had any heart issues since birth so I assume she is OK now....

yes, I really should have added that I also know many women who've had relatively straight forward pregnancies though its policy to induce early. And then if you have had a c-section you are not allowed to be induced so pregnancies 2 & 3 were inevitably 'sun roof' jobs.
More scans seems to mean detecting more potential problems but glad to hear your girl was throughly checked over!