Management of GDM in Labour
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$197
Intrapartum management of gestational diabetes mellitus (GDM) is aimed at maintaining normoglycemia in an effort to prevent neonatal hypogly...
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Intrapartum management of gestational diabetes mellitus (GDM) is aimed at maintaining normoglycemia in an effort to prevent neonatal hypoglycemia. Diet-controlled GDM can usually be managed with frequent monitoring of blood glucose levels and adjustment of insulin or food as needed. Close attention to blood glucose levels is especially important during the labor and delivery process, when there is an increased risk for neonatal hypoglycemia.
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There is good evidence to support the use of universal screening for gestational diabetes mellitus (GDM) in all pregnant women. The American Diabetes Association (ADA) and the Canadian Diabetes Association (CDA) both recommend screening for GDM in all pregnant patients, regardless of risk factors.1,2 The National Institute for Health and Care Excellence (NICE) also recommends screening all pregnant patients.3
The ADA recommends a two-step approach to screening for GDM.1 The first step is a 50-g, one-hour glucose challenge test. If the patient’s blood sugar level is above 140 mg/dL after the challenge test, she should undergo a diagnostic glucose tolerance test. If the patient’s blood sugar level is below 140 mg/dL after the challenge test, she does not need to undergo further testing.
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Related: Self Management of Diabetes Mellitus
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