GDM counselling

Question 1

delivery recommended by

Answer 1

usually on 37/38 wks

(no later than 40+6)

Question 2

intro

Answer 2

what it is
RFs (FHx, prev macrosomic baby, prev still birth)
confirm it goes away on delivery

Question 3

risks to baby

Answer 3

IUGR
macrosomia
stillbirth
preterm birth
shoulder dystocia
neonatal hypoglycaemia
increased lifetime risk DM

Question 4

risk to mother

Answer 4

hypertension/pre-eclampsia
polydramnios
genital tract trauma
higher c-section rate
GDM future pregnancies
T2DM risk

Question 5

format of GDM clinic/care

Answer 5

midwife, obstetrician, endocrinologist, dietician
4-weekly visits (1-2 if high risk)

Question 6

counsel this in any diabetes station

Answer 6

blood glucose control (diet, metformin, insulin)
compliance with diet
self-monitoring

Question 7

safety net for this condition & its symptoms

Answer 7

pre-eclampsia –> more frequent blood pressure measurements

Question 8

delivery info

Answer 8

IOL
by 41 weeks - brought forward by poor control/complications
hospital w/ foetal monitoring

Question 9

postnatal info

Answer 9

monitor baby for 24hrs for hypo
medications stop
1 x BM before discharge; 6w GTT; 16/40 GTT in future pregnancy; yearly HbA1c
encourage breastfeeding (inc antenatal expression)
encourage healthy lifestyle

Question 10

nice guidance

Answer 10

https://www.nice.org.uk/guidance/ng3/chapter/Recommendations#gestational-diabetes