Gestational diabetes elevate glucose level

trimester uncontrolled hyperglycemia

in the first
development
can affect fetal
risk of
are at significant
Patient with GDM in life
intolerance later
development glucose with GDM or
diagnosed early
for patient develop sustained
and also of
in increase risk
obese are 2 diabetes
intolerance and type
glucose that have
changes
degree of vascular
relate to the
occurred over time
all pregnant patient
universal screening
of
recommend become its diffcolt
of hyperglycemia
for the presence symptoms
present without
to defects

Maternal and fetal

Risk 8
eclampsia
develop pre
of
high risk
Patient with GDM for gestation age
dystocia C
section large
or having poorPfington

baby
fetus death hypoglycemia I UGR
The riskthatplace the
 for gestational Diabetes Mellitus
Screening
patient 24 to 28 weeks
all pregnant
recommend for of blood
screening
factor laboratory
assess history
clinical risk
glucose level first Timester
risk factor need toscreen in
with multi
patient the gestation is negative
week and
breform before 24
If screening
28 weeks
recommended
between 24
rescreening
test
There is 2 Type of screening

the one steptest

sequential test
two steptest

do the 2 of test
patient need to type screening
All

thepreferred is two step screening method

Care Antepartum
Nursing
with GDM the tretmatbegin
ifthe patient diagnosed
immediately thefamily find No time to adjust
 educate the thepatient and the family the complicate

should be discussed
Preprandial
blood glucose control Fasting
GDM is meticulous
between 3.8 andS 2mmol14
levelshould be
blood glucose 7.7mmol14
Postprandial between CSS and
meal
I hours after 8.0 and G 6mmol LJ
blood level
2 hours postprandial
metformin are both used for
G boride and
ly control in patient with GDMand
blood glucose
Gm both cross the placenta
increge wight forpregnantpatient
newborn will have hypoglycemia

notworkfor obesitypatient
better than meltformine
pancreas to produce
causethe
more

insulti g
Fetal surveillance 80 chance tohavestillbirth
childdied

with GDM havehigher

patient
week 28 and repeatevery 3,4 week
ultrasound start
in

weekly with nonstress test

When it reach 36 Fetal
surveillance
is recommended
 assessment is recommended
NST and Afl twice week

begain from 23 to 36 week to reduce stillbirth

Intrapartum
lend monitored everyhour
labour blood glucose
during

GDM has been manged on insulin canbe controlled a

by
tht titrated to bloodsugar
scale ofregular is
insulin
gliding
during labour

postpartum

carbohydrate intolerance can be initiated 6week

assess

to Gmonth postpartum or after the breastfeeding has stopped

for develop diabetes required

Obesity risk factor
life change