2. GESTATIONAL DIABETES
RISKS AND FUTURE

5. 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)

6. 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

7. 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

8. 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

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

10. Risks of GDM- To the baby
Shoulder dystocia
Fetal macrosomia

11. 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

12. Neonatal Jaundice
Erb’s Palsy

13. Caudal regression syndrome Birth trauma

14. 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 ?