GDM

Question 1

list risk factors for GDM

Answer 1

ethnicity, BMI >30, mat age >40, prev/family hx GDM, prev LGA, PCOS, multiple

Question 2

list specific aspects of antenatal care for GDM women

Answer 2

referral to dietician/DM educator/endocrinologist, monitor GWG, urine testing for keton/proteinuria

Question 3

describe intrapartum medication and BGL management for GDM women having VB and CS

Answer 3

VB: cease metformin/insulin
CS: cease metformin 24 hours before, usual insulin the night before then cease
BGL monitoring every 2/24

Question 4

describe PP care for GDM women

Answer 4

if metformin or ins: BGL 6/24
rec OGTT within 6-12 weeks and lifelong screening every 3 years
early OGTT in future pregnancies

Question 5

list mat and fetal risk factors for neonatal hypoglycaemia

Answer 5

mat: DM, intrapartum glucose, beta blockers, valproate, hx metabolic disorders
fetal: premature, SGA/IUGR, LBW, LGA, hypothermia

Question 6

list midwifery actions to prevent neonatal hypoglycaemia

Answer 6

keep baby warm, keep dry, early feed 30-60mns from birth, early S2S, avoid separation from mother where possible, assess for risk factors

Question 7

describe fetal consequences of GDM

Answer 7

RDS, prematurity, LGA, hypoglycaemia, jaundice, stillbirth