GESTATIONAL DIABETES RISKS AND FUTURE. GESTATIONAL DIABETES RISKS AND FUTURE.

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Presentation transcript:

GESTATIONAL DIABETES RISKS AND FUTURE

Risk assessment A high risk of gestational diabetes mellitus: marked obesity. personal history of gestational diabetes mellitus. Poly cystic ovarian disease(PCOD). Glycosuria. a strong family history of diabetes . Member of high risk population-e.g Asian,African Presence of multiple risk factors warrants earlier screening (preconception, 1st & 2nd trimester)

Screening for GDM First step: Early identification of risk factors Second step: One hour 50 g glucose screen Third step: Three hour 100 g OGTT for diagnosis

One abnormal Value is enough OGTT –100g –3 hour Test Test sample timing Plasma Glucose value Fasting (mg%) 95 1 hour (mg%) 180 2 hour (mg%) 155 3 hour (mg%) 140 One abnormal Value is enough

Excessive weight gain (obesity) Preeclampsia Polyhydraminos MATERNAL RISKS Excessive weight gain (obesity) Preeclampsia Polyhydraminos Cesarean section Preterm delivery Intrauterine demise Traumatic delivery (e.g.shoulder dystocia) And- Operative vaginal delivery vacuum-assisted forceps-assisted

POLHYDRAMINOS (Excess amniotic fluid). OBESITY (Excess weight gain)

Risks of GDM- To the baby Shoulder dystocia Fetal macrosomia

Risks to the baby (contd.) Macrosomia (Large baby) Shoulder Dystocia ,Erb’s Palsy due to large size of the baby. Neonatal hypoglycemia Neonatal Jaundice Delayed Lung Maturation Hypocalcemia, HypoMagnesmia Still Birth

Neonatal Jaundice Erb’s Palsy

Caudal regression syndrome Birth trauma

FUTURE RISKS OF GDM MATERNAL OFFSPRING Future gestational diabetes in subsequent pregnancy. Subsequent type 2 diabetes and heart disease specially in obese and have family history. Obesity in later life ? IFG, IGT or Dm in later life ?