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Gestational diabetes

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Last update: 
September 21, 2009
Authors: 
Patrice Trauffer
Authors: 
Vincenzo Berghella

Diagnosis/definition

An abnormal 1h GCT is defined at TJU as >=135mg/dL.

Definition of poorly controlled GDM (hyperglycemia): Greater than one abnormal (>105) fasting glucose and/or >=2 abnormal postprandial (>120 at 2hr) per week

Pregnancy Management

Antepartum testing

Ultrasounds: - euglycemia with diet only --growth scan not indicated unless size > dates on clinical exam - poorly controlled (hyperglycemia) and/or medication necessary --growth ultrasounds every 4-8 weeks Antenatal testing: - euglycemia with diet only -- no special testing indicated -- NSTs weekly starting at 40 weeks - poorly controlled (hyperglycemia) or medication necessary - NSTs weekly from 32 to 36 weeks, two-times-per-week from 36 to 40 weeks

Delivery

Induction of labor (or cesarean delivery if indicated by other factors) - at 40 weeks if poorly controlled or on medication - at 41+ weeks if diet controlled with euglycemia