Gdm

From mdEBMwiki
Jump to: navigation, search

Contents

Diabetes in Pregnancy Management Recommendations

[ ] Diagnosed by Random Sugar >200, HgBA1c >7, FBS >126, 3HR GTT> 180, 155, 140 (>2 abnormal levels on GTT)

Initial Testing

[ ] Pre-gestational Diabetes ( MFM Referral, HgbA1c, 24hr urine prot:creat ratio, TSH, T4, EKG, Eye Exam by Ophtho, Targeted Fetal Anatomy U/S @ 20 weeks, Fetal 2D Echo @ 20 weeks )

[ ] Gestational Diabetes (Nutritionist Counciling, MFM Refferal, Target sugars: FPG <95, 1HR Post Prandial <140)

Therapeutics

[ ] Low-dose Aspirin for Pre-gestational diabetes starting at 12 weeks

[ ] Insulin, Metformin, Glyburide

[ ] ~1800-2500kcal diet

Antenatal Testing

[ ] Pregestational Diabetes & Medication Controlled GDM - Growth ultrasound q4 weeks starting at 28 weeks, Biweekly Testing (?BPP + NST) @ 28-32 weeks.

[ ] Gestational Diabetes (Diet Controlled) - daily fetal kick count, no biweekly antenatal testing, consider growth US @ 36 weeks.

Delivery Timing

[ ] 39 weeks if BS well-controlled, Consider elective C/S if >4500grams

[ ] 34-39 weeks if BS poorly controlled per MFM only.

Postpartum Visit

[ ] Nonpregnant GTT @ 6-12 weeks, Ideal Body Weight goal.


Sources

ACOG GDM, Zheng Redbook

Personal tools