GDM Diagnosis Explanation

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

2024
Views:

40

Pages:

3
Author:

Mariam A. A.

GDM Diagnosis Explanation and Implications Hi Mrs. Khan, I hope you are doing well. Based on the tests we have done it seems that you have gestational diabetes. This is one of the common complications that women experience in pregnancy. 10 to 15% of women are impacted by it. It happens due to hormonal changes that happen in pregnancy For example, increased cortisol, placental lactogen, CRH and growth hormone are all hormones that increase insulin resistance Other risk factors include: Having it before Obesity or excess weight gain in pregnancy Family history Multiple gestations Large foetus Preexisting diseases such as PCOS Previous large foetus This is different to DM Because for a woman to be diagnosed with GDM she much not has a prior diagnosis of diabetes prior to pregnancy. It usually resolves after pregnancy Has a lower risk of teratogenesis than DM -> i.e. malformations for your baby However, there is a greater risk of delivering a large baby compared to DM Implications For mother Increased risk of c section Increased risk of infections Increased risk of hypertensive disorders Increased risk of having it again in future pregnancies Increased future risk of cardiovascular, BP and diabetes risk. For foetus High weight birth Hypoglycaemia Initial Management Plan Don’t worry though most women manage well and there are steps that we can take Lifestyle Limit weight gain Exercise Good diet Consider 5 smaller meals than three big meals Ideally your plate should be divided as: Half vegetables Quarter proteins Quarter carbs e.g. rice or pasta And a little bit of good fats such as avocado Avoid smoking, alcohol and drugs. Metformin If lifestyle and metformin do not improve symptoms within a week -> then commence insult You also need to check your blood sugar levels four times a day Once fasting And the other three times after meals You would need monthly HbA1C measurements You would need fortnightly ultrasound monitoring To monitor for baby’s growth and the fluid around the baby as well as congenital abnormalities We also need to plan for delivery We usually prefer to induce labour at 38 to 39 weeks GDM alone is contraindication to vaginal delivery, and we recommended it there are no other commodities and your diabetes is well controlled. If poorly controlled we need c section -> macrosomia, fetal distress, delayed lung maturity, stillbirth If your baby’s weight exceeds 4.5 kg, then we strongly recommend a C section