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This Concept Map, created with IHMC CmapTools, has information related to: Medical Conditions in Pregnancy, Pregnancy Conditions Gestational Diabetes 7-9% US pregnancies 90% GDM (not I or II) 3-5% remain pregnant White's Classes A1-GDM, diet controlled A2-GDM FBS, 2-hr PPBS -insulin Tx B-DM > 20yo, yr C-DM ងyo or ᡂyr duration D-DM 10-19yo, 10-19yr dur, OR retinopathy F-w/ nephropathy R-w/ prolif retinopathy H-w/ arteriosclerotic heart dz, Pregnancy Conditions Gestational Diabetes 7-9% US pregnancies 90% GDM (not I or II) 3-5% remain pregnant Mom Morbidity -Retinopathy -Pre-Eclampsia -Infx (UTIs, pyelo), Pregnancy Conditions UTIs UTIs -25% of preggers -TREAT ALL UTIs even if no Sx, Pregnancy Conditions Gestational Diabetes 7-9% US pregnancies 90% GDM (not I or II) 3-5% remain pregnant Acute hypoglycemia Tx: 4oz juice -ᡇmin->check BS -may need to repeat OR if unconscious -Glucagon 1mg -raises 30-40mg/dL, Pregnancy Conditions Gestational Diabetes 7-9% US pregnancies 90% GDM (not I or II) 3-5% remain pregnant Tx: Diet: 45% CHO 25% protein 30% fat -always balance CHO Rx: Insulin (.7-1U/kg) (more if obese) Glyburide (sulf'urea) Acarbose Metformin-little known, Pregnancy Conditions Gestational Diabetes 7-9% US pregnancies 90% GDM (not I or II) 3-5% remain pregnant TIGHT CONTROL FBS៊ Preprandial៏ 1hr post Mean daily HbA1C 4-6, Pregnancy Conditions Gestational Diabetes 7-9% US pregnancies 90% GDM (not I or II) 3-5% remain pregnant Monitoring -Weekly BPP -Twice-wkly NST -Daily kick counts Delivery at ᡟwks -maturity at 38.5, Pregnancy Conditions Gestational Diabetes 7-9% US pregnancies 90% GDM (not I or II) 3-5% remain pregnant Neonatal Morbidity Macrosomia 15% ->dystocia Hypoglycemia 20% Hyperbili 15% Hypo-K, Hypo-Ca Polycythemia Polyhydramnios 10% (Oligo in DM-I) Sacral agenesis Stillbirth Later obesity, diabetes, Pregnancy Conditions UTIs Pyelonephritis -ᡌ% to PTL or high uterine activity Treat fever Use tocolytics to prevent PTL, Pregnancy Conditions Gestational Diabetes 7-9% US pregnancies 90% GDM (not I or II) 3-5% remain pregnant Screening at 24-28wga Abnormal values 1. 50mg glucola - (90% sens) 2. 100mg glucola (2ABNL) - FBS ᢗ 1hr-180 2hr-155 3hr-140 3. OR random , FBS