Pre, intra and post management of certain conditions

Question 1

Intrapartum management of GDM

Answer 1

Monitor glucose every hour aiming for between 4 and 7
Use IV insulin or dextrose to correct

Question 2

Post natal management of GDM

Answer 2

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

Question 3

When have fasting glucose done at 6 weeks post birth with GDM, what are categories

Answer 3

Under 6
6.0-6.9
7 or more

Question 4

If at fasting glucose 6 weeks post GDM it is under 6 what do

Answer 4

Low chance of DM so advise on how to avoid DM
Repeat fasting glucose annually

Question 5

If at fasting glucose 6 weeks post GDM it is 6-6.9 what do

Answer 5

At high risk of developing DM so offer lifestyle interventions

Question 6

If at fasting glucose 6 weeks post GDM it is 7 or more what do

Answer 6

Might have T2DM so initiate diagnostic testing

Question 7

Postnatal management of pre-eclampsia HTN

Answer 7

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

Question 8

What determines when to deliver with GDM

Answer 8

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

Question 9

How is glucose managed during birth in T1 and T2DM

Answer 9

Variable sliding scale for glucose

Question 10

Management of epilepsy during labour

Answer 10

Take AEDs as normally would