Gestational diabetes Flashcards
1
Q
Definition
A
Carbohydrate intolerance which is diagnosed in pregnancy and may or may not resolve after pregnancy
2
Q
Risk factors
A
Persisting glycosuria 1+ or greater Obesity Family history of diabetes Previous history of gestational diabetes mellitus Foetal macrosomia Previous unexplained intrauterine death PCOS South Asian, Black Caribbean, Middle Eastern
3
Q
Screening
A
Screen at 28 weeks for above risk factors - excluding previous hx of GDM (screen at 18 weeks) - plus if polyhydramnios
Use an OGTT (>7.8 after 2 hours)
4
Q
Foetal complications
A
Preterm labour Reduced foetal lung maturity Macrosomia Polyhydramnios Shoulder dystocia and birth trauma Fetal compromise, foetal distress in labour and sudden foetal death
5
Q
Maternal complications
A
Hypoglycaemia due to attempt at tight control
Pre-eclampsia
Prolonged labour
Increased instrumental delivery and C-section
PPH
Nephropathy/retinopathy
6
Q
Management
A
Tight glucose control Lifestyle - diet and exercise Oral hypoglycaemic agents eg metformin Insulin Discontinue insulin post-natally, but OGTT at 3 months
