In this mailbag episode of the Healthful Woman podcast, Dr. Nathan Fox answers listener questions about pregnancy. He covers continuous glucose monitors for gestational diabetes, umbilical cord edema, fetal movement with an anterior placenta, chemotherapy exposure for pregnant nurses, and pregnancy after placenta accreta spectrum. As in past mailbag episodes, he is candid about what the research shows and where it falls short.
Continuous Glucose Monitors for Gestational Diabetes
A listener who had gestational diabetes asked about continuous glucose monitors (CGMs). Traditionally, patients check their blood sugar with finger sticks four times a day: fasting in the morning and after each meal. Those numbers guide changes to diet and nutrition and decide whether medication is needed. A CGM is a small sensor worn under the skin, usually on the back of the arm, that sends readings to a phone.
Does it improve outcomes? “Right now, I would say, unknown,” Dr. Fox says. Because of that, CGMs aren’t universally recommended and some insurers don’t cover them. They offer convenience and detailed data, but frequent alarms can add anxiety. His practice is comfortable with patients who want to use one.
Umbilical Cord Edema
A NICU nurse asked about umbilical cord edema, meaning swelling or thickening of the cord, which was noted after her complicated delivery. Dr. Fox explains that in most cases “it is an incidental finding,” and “we don’t normally measure cord thickness on ultrasound.” It matters more when it comes with generalized swelling in the baby, called hydrops. When the cord edema is isolated, it is probably unrelated to bleeding or other delivery complications.
Fetal Movement With an Anterior Placenta
One mother whose placenta was anterior, on the front wall of the uterus, found her baby’s movements hard to track. An anterior placenta acts like a cushion, so kicks feel softer and are noticed later in pregnancy. Dr. Fox notes that research hasn’t shown formal kick counting prevents stillbirth. Still, any change in movement is taken seriously and checked with ultrasound or a non-stress test. Most of these evaluations turn out reassuring. You can read more about movement in late pregnancy in our earlier post.
His advice is to learn what normal looks like for your baby and speak up when something feels different. For patients who stay anxious, regular check-ins can help: “Does it help relieve anxiety? Definitely.”
Chemotherapy Exposure for Pregnant Nurses
An oncology nurse asked whether hanging chemotherapy infusions is safe during pregnancy. Dr. Fox describes three levels of exposure. Being in the room with a patient getting chemotherapy is considered safe. Handling and hanging the bags carries some risk, “but it’s very, very low,” especially now that pharmacies mix the drugs and nurses wear gowns and double gloves. Older studies that raised concern came before these precautions. With them in place, he says, “that is probably safe to do.” Nurses who still feel uncomfortable can reasonably ask for accommodations.
Pregnancy After Placenta Accreta Spectrum
The final question came from a mother with two prior pregnancies complicated by retained placenta, a form of placenta accreta spectrum. Severity ranges widely. Her history falls in the middle, where part of the placenta stays behind after delivery and can cause heavy bleeding. A third pregnancy could go smoothly or bring similar complications. Planning matters: serial ultrasounds, delivering at a hospital with an accreta program and a blood bank, and alerting the delivery team ahead of time.
Learn More
Listen to the full episode of the Healthful Woman podcast to hear Dr. Fox’s complete answers.
If you are expecting and have questions about your pregnancy, Carnegie Women’s Health provides compassionate, personalized care for women at every stage of life, and partners with maternal-fetal medicine specialists when a pregnancy needs extra care. Contact Carnegie Women’s Health through the online appointment request form to schedule a visit.
Carnegie Women’s Health blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!
