Dr. B,
Thank you for your answer. Question...the testing of the lupus anticoagulant, anti-cardiolipin antibody, and perhaps a karyotype. I know you stated that these tests are looking for any cause other than the obvious blood pressure/diabetes combination. My current OB stated that since I tested negative for other clotting disorders such as Factor V Lieden then there was no need to further test for Lupus. Is this true or rather is it possible to not have any clotting disorders and still test positive for one of the test you suggested? Also when is it necessary to get a HSG done?
Hi!
I'm sorry for your losses! And I DO hope you will perservere for a live birth! You are on the right track with weight loss! That will help your blood pressure and diabetes both. I hope a good aerobic exercise program is part of your weight loss campaign.
If you were my patient, I would want the blood pressures and blood sugars controlled BEFORE conception as that will reduce your risk of birth defects. I would also advise you to stop smoking if you do(you don't do you?).
I would also consider a few other tests (these can run into major $ however) I would want to test you for lupus, the lupus anticoagulant, anti-cardiolipin antibody, and perhaps a karyotype. These tests are looking for any cause other than the obvious blood pressure/diabetes combination.
Glyburide is safe during pregnancy, but for optimal control, you might consider switching to the gold standard/ time-honored insulin. Your blood pressure medications were appropriate too, but even better if you can bring your blood pressure down without medication.
Finally, for best results during next pregnancy, weekly visits with review of blood sugar charts, blood pressures, and a dietician and MFM from the very start!
By the way--have you had a good eye exam?
I wish you all the best!
Dr B