Counselling a Diabetic Patient Before Pregnancy | Western Sydney University - Edubirdie

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

272

Pages:

5
Author:

Mariam A. A.

Counselling a diabetic patient before pregnancy History Age at diagnosis How well controlled are your diabetes? Are they being managed? How is it being managed? Are you compliant? m Are you symptomatic? If yes, what features How often are your glucose levels measured? What is the most recent reading Menstrual cycle history Regularity Colour Amount How many pads do you change? Clots Duration Pain Flooding Staining of clothes Contraception Vaginal discharge -> if yes Colour Amount Consistency Blood Frequency Sexual history Active? Number and gender of partners Protection Counselling Prior to pregnancy Importance of control for fetal abnormalities and later pregnancies Esp HbA1c Should not get pregnant until glucose levels are optimal Baseline line investigations Consider dietitian visit prior to conception To prevent spina bifida -> take 5mg of folate at least from three months before and throughout first trimester May need to refer to podiatry and optometry Retinopathy and nephropathy in screening Screening for infections Rubella and other STIs Pre-pregnancy vaccines e.g. rubella, varicella, influenza, pertussis Estimate risk of PET Antenatal management Tight control and monitoring Four times a day Both fasting and postprandial (1 to 2 hrs after meals) HbA1c -> every 4 to 6 weeks POGGT No need for a high carbohydrate diet before hand U/S Vaccinations e.g. whooping cough, tennatus Lifestyle Delivery Timing and mode of delivery -> will depend on fetal assessment Vaginal delivery still possible But risk of shoulder dystocia Higher risk -> because the biacromial diabetes (shoulder width is increased)

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Counselling a Diabetic Patient Before Pregnancy

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