Second Pregnancy After Gestational Diabetes & Pre-eclampsia: Risks & Concerns

Question
I just turned 37 years old on May 10th. I have one son who is 5 years old and we would like to have another soon. When I carried my son, I had gestational diabetes and was insulin dependant from 5 months to delivery, which I delivered 6 weeks early due to H.E.L.P. and pre-eclampsia disease. I had very high blood pressure which did not go down for at least two years after having my son. What I would like to know is...does that mean my second pregnancy will be just as unhealthy as my first? This is my only worry about having another child. I was also 40 lbs. overweight when i got pregnant, which did not help any, but I have lost weight, changed my eating ways and walk now :). Thank you very much. Melody from New Hampshire

Answer
If you had gestational diabetes with your first pregnancy, it is quite likely that you may have it again during your second. YOu should be tested early in the pregnancy and be on a strict diabetic diet throughout the pregnancy. Since you had also developed HEELP syndrome, you obviously had preeclampsia and have to be on the lookout for PIH (pregnancy induced hypertension). Since the blood pressure remained high for two years afterwards, you probably have a component of chronic hypertension, as well, and may need antihypertensive medication during the pregnancy. With your past history, you are considered a "high risk pregnancy" and should be monitored carefully. HOwever, as long as you follow a strict diet and are monitored carefully (Non Stress Testing, biophysical profiles, checking your blood glucose, etc) you should have a healthy and comfortable pregnancy.