Your Pregnancy After 35 : Your Health and Medical History (part 3) - Celiac Disease, Chicken Pox, Cytomegalovirus , Diabetes

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9. Celiac Disease

Celiac disease is a digestive disease that affects the small intestine. If you have celiac disease, you have an allergy to gluten, which causes your intestines to absorb fewer nutrients. Symptoms include diarrhea, abdominal pain, bloating, irritability and depression.

The condition is hereditary and occurs more often in women than men. It’s most common in Western Europeans. We believe celiac disease affects 1 in 100 people worldwide and 1 in every 250 Americans. It may be overlooked during pregnancy because symptoms can be the same as for other pregnancy problems. Many healthcare providers don’t know much about the disease, and it can be difficult to diagnose. A blood test can determine if you may have celiac disease. A biopsy of the small intestine can confirm it.

If you have celiac disease, it’s important to eat a gluten-free diet. You will probably need folic-acid supplements to ensure you receive enough folic acid.

Celiac disease may appear for the first time during pregnancy or after childbirth. If you have symptoms, talk to your healthcare provider. You may need to see a dietician during pregnancy to develop a nutrition plan.

10. Chicken Pox (Varicella)

Herpes is a family of viruses that includes the herpes-simplex virus, herpes varicella-zoster virus and cytomegalovirus. The word chicken pox is used interchangeably with varicella. (It is also used to describe the rash seen with chicken pox.) The term herpes zoster is used interchangeably with shingles.

When adults get chicken pox, they can become very ill. The most serious times for you to get chicken pox are during the first trimester and around the time of delivery. A baby can get the virus during delivery, which could cause a serious infection.

11. Cytomegalovirus (CMV)

Cytomegalovirus (CMV) is a member of the herpes-virus family and is transmitted in humans by contact with saliva or urine. Day-care centers are a common source of the infection; CMV can also be passed by sexual contact. Most infections do not cause symptoms; however, when symptoms occur, they include fever, sore throat and joint pain.

CMV is the most common virus passed from a mother-to-be to her baby during pregnancy. It infects about 1% of all newborns. Infection can cause low birthweight and other problems in a baby.

12. Diabetes

Diabetes is one of the most common medical complications of pregnancy. It occurs in 7 to 8% of all pregnancies. Today many diabetic women go through pregnancy safely.

Diabetes is defined as a lack of insulin in the bloodstream or a resistance to insulin by the body’s cells. Pregnancy increases the body’s resistance to insulin, and the body doesn’t process insulin efficiently. If you don’t have insulin, you will have high blood sugar and a high sugar content in your urine.

Pregnancy is well known for its tendency to reveal women who are predisposed to diabetes. Women who have trouble with high blood-sugar levels during pregnancy are more likely to develop diabetes in later life.

Some experts recommend screening pregnant women at risk for diabetes during the first trimester. Others recommend testing all pregnant women at 28 weeks of pregnancy. Tests used most often are the glucose-tolerance test (GTT) and/or a 1-hour glucose challenge test.

If you have diabetes or know members of your family have diabetes, tell your healthcare provider. This is important information.

Diabetes and Pregnancy

Diabetes can cause various problems during pregnancy. Birth defects may be more common. It’s important to take care of diabetes before pregnancy. If your diabetes is not controlled during pregnancy, your baby is at greater risk.

If you take insulin, you may need to adjust your dosage or the timing of your dosage. You may also have to check your blood-sugar levels 4 to 8 times a day. You must balance your eating plan and your insulin at all times so your glucose levels don’t climb too high. Avoid long-lasting insulin during pregnancy. It may also help if you take in more folic acid; discuss it with your pregnancy healthcare provider and endocrinologist.

Some women take diabetes pills; some oral antidiabetes medications taken during pregnancy may cause problems for the developing baby. (Metformin is not recommended during pregnancy.) There are safe oral medications for diabetes in pregnancy. You may have to adjust the amount of oral medication you take, or you may need to switch to insulin shots. Your healthcare provider can advise you.

13. Diarrhea during Pregnancy

Diarrhea during pregnancy can raise concerns. If it doesn’t go away in 24 hours or if it keeps returning, contact your healthcare provider. He or she may prescribe medication for the problem. Do not take medication for diarrhea without first discussing it with your healthcare provider.

One of the best things you can do for yourself if you experience diarrhea during pregnancy is to increase your fluid intake. Drink a lot of water, juice and other clear fluids, such as broth. (Avoid apple juice and prune juice because they are laxatives.) You may feel better eating a bland diet, without solid foods, until you feel better.

It’s OK to avoid solid food for a few days if you keep up your fluid intake. Solid foods may actually cause you more gastrointestinal distress when you have diarrhea. Avoid milk products while you have diarrhea; they may make it worse.

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