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Renelle Stauffer enjoys a laugh with her son, Isaac
Shortly after moving to the area last year, Renelle Stauffer and her husband, John, were overjoyed to learn they were going to be first-time parents.
Yet Stauffer also knew she and the baby were at risk for complications because she has type 1 diabetes, a condition that prevents the body from producing enough insulin. Pregnant women with preexisting diabetes (or those who develop gestational diabetes during pregnancy) have higher risks for birth defects, miscarriage, preterm birth, high blood pressure issues and a larger than-normal fetus.
“Because I knew the risks of not controlling my blood sugar, I turned to my care team for help,” says Stauffer, 29, of Easton.
A ‘one-stop shop’
From the start of her pregnancy journey, Stauffer relied on Lehigh Valley Health Network’s (LVHN) Comprehensive Diabetes in Pregnancy Program. It includes maternal fetal medicine (high-risk pregnancy) specialists, endocrinologists, nutritionists, diabetes educators and nurse practitioners, all providing coordinated care.
“Diabetes complicates about 10 percent of all pregnancies we see at LVHN,” says maternal fetal medicine specialist Meredith Rochon, MD, with LVPG Maternal Fetal Medicine–3900 Hamilton Blvd. “The good news is that optimal control of blood sugar, which rises during pregnancy due to hormonal changes, significantly decreases the risk for maternal, fetal and neonatal complications.”
Throughout her pregnancy, Stauffer visited the program’s specialists once a month. She met with Rochon, who carefully monitored her and the baby to make sure the pregnancy was proceeding without problems. Monthly ultrasounds showed the baby was growing normally.
Stauffer also saw LVHN endocrinologist Marc Vengrove, DO, with LVPG Endocrinology–1243 Cedar Crest, to track her changing blood sugar levels and insulin requirements. Between monthly checkups, she was able to download her blood sugar values and insulin pump settings to a secure website. Vengrove reviewed this information at least once a week and made adjustments in her insulin doses to optimize blood sugar control.
At one point, when her blood sugar started spiking after breakfast, Vengrove and the team recommended Stauffer substitute the whole-grain cereal she usually ate with more eggs and other lower-carb foods.
“A baby’s brain uses blood sugar almost exclusively, so you want adequate carbohydrates (which break down into sugar) to make sure the baby is getting enough nutrition,” Vengrove says. “But you don’t want blood sugar going too high after you eat because it isn’t healthy for the baby. Renelle is a nurse and really understood the importance of counting carbs and staying on a schedule.”
April Fool’s joy
To ensure a safe delivery, Stauffer’s team decided early on to induce labor by 39 weeks (the average pregnancy is 40 weeks) so the baby did not grow too large.
The Stauffers arrived at Lehigh Valley Hospital–Cedar Crest on the evening of March 31. The plan was to have a normal vaginal delivery before midnight so the baby wasn’t born on April Fool’s Day. “We worried that he’d be teased all his life,” Stauffer says.
But after labor started, it was clear there was a problem unrelated to Stauffer’s diabetes. “The baby wasn’t coming out, and his heart rate was dropping,” she says. “They had to perform a cesarean section and discovered the umbilical cord was wrapped around his neck twice. He ended up being born on the morning of April 1 after all.”
Baby Isaac was monitored briefly in the NICU (neonatal intensive care unit) to make sure his blood sugar was normal. Soon he received a clean bill of health.
“The Comprehensive Diabetes in Pregnancy Program allowed me to see my doctors at the same time and have close contact with them electronically between visits,” Stauffer says. “We want more children, and I’m sure with the program's care, my next pregnancy also will be problem-free.”
–Sidney Stevens