Get the Best Pregnancy and Obstetric Services in San Antonio, TX

There are two kinds of diabetes in pregnancy. The first is “pre-gestational” meaning that you already have diabetes before becoming pregnant. In this case, you will likely be very familiar with taking care of your blood sugars. There are some differences; however, when you are pregnant, you will be referred to a high-risk MD and a dietician who will review these differences and help you control your blood sugar. You will still see us in the office and be delivered by us. The other type is “Gestational Diabetes,” which is diabetes that develops in pregnancy. We screen every pregnancy for this between 26-30 weeks. If you have an abnormal screen, then you will have another test, which is a “diagnostic test,” and if that test is abnormal, then you have gestational diabetes. At that point you will have a dietary evaluation and a consultation with a high-risk doctor. Most women can control their blood sugar with their diet. If blood sugar is not well controlled with diet, then we will start a pill or, as a last resort, insulin injections.

High blood pressure (hypertension) is one of the more common complications we deal with during pregnancy. Women who have elevated blood pressure before the 20th week generally have what is called Chronic Hypertension and occasionally require treatment with oral medication. Women who develop hypertension after the 20th week of gestation have what is called pregnancy-induced hypertension. If you develop this, we will want to watch you closely to make sure you do not develop Preeclampsia. This is achieved with frequent visits for blood pressure checks and urine tests for protein, as well as blood work. Occasionally, if you do develop Preeclampsia, it could mean that your baby will need to be delivered. Hypertension related to pregnancy generally resolves after delivery.

Anyone who delivers a baby after the age of 35 is considered advanced maternal age and is at increased risk for certain complications of pregnancy. Patients who are older when they become pregnant are at a greater risk for certain congenital disabilities such as Down’s syndrome. They also are more likely to have other medical problems that complicate pregnancy, such as hypertension, diabetes, thyroid disease, etc.

There are two types of thyroid disease: Hyperthyroidism (too much thyroid hormone) and hypothyroidism (too little thyroid hormone). Hyperthyroidism is relatively rare in pregnancy and can be treated with medications. Hypothyroidism is much more common and is treated with replacement thyroid hormone. If you have hypothyroidism, we will check your thyroid level at least every 2-3 months to be sure that you have enough.

With the advent of assisted reproduction, the incidence of twins, triplets, and higher-order multiples is increasing. Multiple pregnancies are considered high risk because they are at increased risk for certain complications such as pre-term labor/delivery, Preeclampsia, and diabetes. We monitor twin pregnancies very closely with ultrasound and consultation with the perinatologist if necessary.

Many diseases cause your blood to clot more easily than it normally should. Many are genetic; some are acquired. We can do blood tests in the office to check for them. Drs. Moore and Jewell have had many successful pregnancies of patients with these conditions. As more and more of these diseases are discovered, the panel of labs gets more involved. Two of the disorders we check for have been discovered in the past ten years, and there are probably more to be discovered. These diseases have not been well studied in pregnancy. Most of the research is in the cardiovascular realm, but we think these diseases can cause miscarriage or even stillbirth. The theory is that clotting happens in the placenta or uterus, blocking the blood supply of the developing baby. There are many safe treatments for them, and Dr. Aguilar is well-versed in treating these various disorders.