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What precautions should I take during pregnancy?

Q: I am a 29 years old woman who had preterm labour at 24 weeks and delivered a stillborn baby. My blood sugar levels were slightly high when I had my second trimester tests, but I was not put on any medication. I had developed urinary infection too, for which I was given medications. But I started bleeding and when the doctor checked and she said I had started labour and it could not be stopped. Now I am planning to conceive again. What precautions should I take this time? Please advise.

A:You should be thoroughly checked for diabetes mellitus with an oral glucose tolerance test and HbA1C. There is nothing like 'slightly high' sugar levels in the second trimester. The preterm delivery may have been due to the urinary tract infection and uncontrolled diabetes. This time around your blood sugar and HbA1C must be normal for at least 12 weeks before you become pregnant and folic acid (5 mg) should be started at the same time. Normally the condition called 'gestational diabetes' occurs after 20 weeks of pregnancy and post pregnancy sugar values become normal. You must plan your next pregnancy at least 6 months after your delivery date consulting both an obstetrician and endocrinologist who will be able to tell you whether you whether you have 'overt' or 'gestational' diabetes and plan management accordingly.

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