Pre, intra and post management of certain conditions Flashcards
Intrapartum management of GDM
Monitor glucose every hour aiming for between 4 and 7
Use IV insulin or dextrose to correct
Post natal management of GDM
If new onset GDM- stop all medications after birth, offer fasting glucose 6 weeks after
If T1DM- put on sliding scale and when starts eating again give pre-pregnancy dose
If T2DM- can resume metformin but avoid others
When have fasting glucose done at 6 weeks post birth with GDM, what are categories
Under 6
6.0-6.9
7 or more
If at fasting glucose 6 weeks post GDM it is under 6 what do
Low chance of DM so advise on how to avoid DM
Repeat fasting glucose annually
If at fasting glucose 6 weeks post GDM it is 6-6.9 what do
At high risk of developing DM so offer lifestyle interventions
If at fasting glucose 6 weeks post GDM it is 7 or more what do
Might have T2DM so initiate diagnostic testing
Postnatal management of pre-eclampsia HTN
If over 160/100 then have to stay in
If over 150/100 then must be monitored every 2 days
If less than 150/100 checked weekly and weaned off anti-hypertensives
If less 130/80 can stop anti-hypertensives
What determines when to deliver with GDM
Managed on lifestyle and no macrosomia- before 40+6
Managed with medication and no complications- 37-38+6
Managed with medications and controlled poorly- before 37
How is glucose managed during birth in T1 and T2DM
Variable sliding scale for glucose
Management of epilepsy during labour
Take AEDs as normally would