Third Trimester Labs Flashcards
who gets tested for gestational diabetes?
everyone
why do we not used hemoglobin A1c?
A1c is an average of the past 3 months
diagnosis of gDM, diabetes must occur after wk 20
what screening do we avoid?
fasting glucose
when is screening for gDM performed?
between 24-28wks, earlier if risk factors
what are the risk factors for gDM?
GDM in prior pregnancy
known impaired glucose metabolism
BMI >30
what to do if early screening (for increased risk factors) is negative?
re-screen at 24-28wks
how to screen for gDM
1hr glucose challenge test (1-GCT)
what is a positive 1hr glucose challenge test (1-GCT)?
> 140
what to do if 1hr glucose challenge test is positive?
3hr glucose tolerance test (3-GTT)
what is a positive 3-GTT?
positive if 2/2:
- fasting >95
- 1hr > 180
- 2hr > 155
- 3hr > 140
how to run the 1-GCT
give 50g oral glucose load, check sugar at 1hr
how to run 3-GTT
past positive 1-GCT
- fasting blood sugar first
drinks 100g glucose
- check sugar every hour for 3hrs
what to screen Rh negative moms for
Rh-IgG-Antibody
- if positive, it’s too late and mom is primed to attack Rh-antigen-positive baby
what to do if mom is Rh-negative and antibody negative AND dad is Rh+ or Unknown?
protect mom from developing antibodies against rhesus antigen by giving Rho(D) Immunoglobulin
when to give Rho-Gam?
28wks and delivery
