Q: My wife is 31 years old and we had two normal pregnancies. One child is nine years and the other is two years old. Three years back my wife developed diabetes and her sugar is around 150-170 pre and post fasting. Her HbA1c measured last year was around 7.70. Please advise whether we can plan for third pregnancy?. If yes, what safeguards should we take?

A:It is better to avoid a third pregnancy for many social and medical reasons. If you are, however, determined for a third child, then there is a risk of the diabetes worsening during the pregnancy with risk of many complications in the baby which may need admission and treatment in the nursery after birth. The pregnancy will need close monitoring throughout the nine months with advice of a special diet and possibly, treatment with insulin in later months if the sugars go beyond 200. If the baby size is too large (diagnosed by repeated ultrasounds) she may need an operative delivery-All problems depend upon how well the sugars are controlled during the pregnancy. A low risk of congenitally abnormal baby is also there which will need to be ruled out at 18-20 weeks by ultrasound.