GDM

Question 1

GDM - epi

Answer 1

6-8%

Question 2

GDM - RF

Answer 2

1. Fhx T2DM
2. Phx GDM
3. BMI>30
4. PCOS
5. Older maternal age

Question 3

GDM - sx

Answer 3

1. Usually asymptomatic, dx at screening
2. Hyperglycaemia -> polyuria, polydipsia
3. Elevated fundal height bc polyhydramnios or macrosomia

Question 4

GDM - screening

Answer 4

1. Universal screening 24-28 wks
2. 75 g OGTT. Any of the following:
3. Fasting glucose ≥ 5.1 mmol/L
4. 1 hour level ≥ 10.0 mmol/L
5. 2 hour level ≥ 8.5 mmol/L

Question 5

GDM - mx (antenatal)

Answer 5

1. Ax end-organ involvement - retinopathy, nephropathy, CVD
2. BGL control - normoglycaemia
3. Diabetic diet and daily exercise
4. If BGL targets not met, insulin +/- oral hypoglycaemic agents (sulfonylureas or metformin)
5. Regular U/S to identify growth restriction/accelerated growth

Question 6

GDM - mx (labour)

Answer 6

1. Delivery after 38 weeks if poor control/fetal involvement
2. Maintain good glycaemic control in labour
3. Close fetal monitoring
4. Close neonatal follow-up (hypoglycaemia, jaundice, RDS)
5. Check glucose prior to discharge to ensure normal