I am currently 33 weeks pregnant, and was diagnosed at 29 weeks with gestational diabetes.  I have monitored my blood sugar, and it rarely goes over 100 without any change in my diet.  I have been extremely unhappy with the way that my doctors are treating the entire thing.  I have an extra placental lobe, and I am wondering if that could possibly have caused the gd since i am only 25, was a normal weight pre-pregnancy, have only gained 18 pounds, have normal blood pressure, no history of diabetes in my family, and no high blood sugar when testing...I eat well, excercise, etc... also, at my last doctors appointment, he made mention of doing an ultrasound every four weeks from now forward- is this something i should agree to?

Hi Maria,

I guess I should have further explained the extra placental lobe. it does not mean that i was carrying twins whatsoever, and it will not mean anything for my pregnancy except that they retrieve the second placenta as well as the first.  This is my first child, no scar tissue...The doctor told me right away that it was nothing to be concerned about and is actually quite common. 

My question is that because the placenta is what secretes the excess hormones making it more difficult for the pancreas to produce insulin, having an extra placental lobe could mean that it is the cause of the extra hormones and could mean that if I do not have an extra placental lobe in future pregnancies, i do not need to worry with any of this.  does that make sense??

I have read Henci's article and found it very informative.

You could be right about the placental lobe, but it could also be just one of those things. Now that you have the diagnosis, the issue now, though, is making informed decisions about your care, which means gathering information about your options. I don't know whether you should agree to testing or not, but  you can find out for yourself. There are questions you can ask that will tell you this such as.

• What information do you hope to gain from this test?
• How accurate or reliable is this test?
• What actions or further testing will you recommend if the test indicates a problem?

I can also tell you in general that inducing labor for suspected big baby has not been shown to improve outcomes and increases risk of cesarean surgery in first-time mothers. Routine surveillance tests of fetal well-being have also not been shown to improve outcomes but can lead to unnecessary interventions on the basis of false-positive results.

If you feel your dr may be overly alarmist, one litmus test of your dr's practice style and philosophy is to find out his or her cesarean rate. Your dr's cesarean rate is a strong indicator whether you can rely on your care provider's judgment in other matters. If you hear anything over 15%, your dr is exceeding the limit that can be achieved with good outcomes in the typical practice population. 

-- Henci

I am 38 and pregnant with my 5th child.(they will be 18 months apart)  With my fourth I had placenta previaI had a c-section at 36weeks. Because of my age, I  opted to see a specialist to do a detailed ultrasound.  He informed me of the extra placenta lobe and advised that it was nothing to worry about.  I questioned my regular OB and he also said it isn't anything to worry about especially becaused I am already down for another C-sec.  He told me the only danger is it not getting delivered at birth and that would cause problems.  I don't know about it causing gd or anything else. I haven't had any problems other than all day nausea that in my 16th week has finally let up.

I cannot help asking whether you agree with the decision to perform repeat cesarean surgery or whether you haven't thought much about it one way or the other. I ask because with three prior vaginal births and a normal pregnancy, you would appear to be an optimal candidate for vaginal birth after cesarean (VBAC). If you haven't thought much about it, you may wish to explore the benefits versus harms of planning vaginal birth compared with elective repeat surgery, in which case, I recommend VBAC or Repeat Cesarean Section?

-- Henci