A Practical Manual of Diabetes in Pregnancy (McCance/A Practical Manual of Diabetes in Pregnancy) || Rationale for Treatment of Hyperglycemia in Pregnancy

✍ Scribed by McCance, David R.; Maresh, Michael; Sacks, David A.

• Publisher: Wiley-Blackwell
• Year: 2010
• Weight: 712 KB
• Edition: 1
• Category: Article
• ISBN: 140517904X
• DOI: 10.1002/9781444315196.ch7

✦ Synopsis

ultrasound scans of head circumference at 31, 33, 35, and 37 weeks were all at the 75th centile, but the abdominal circumferences were on the 97th centile at 31 and 33 weeks, and on the 90th centile at 35 and 37 weeks. This suggests a positive response to the insulin prescription in preventing a recurrence of fetal overgrowth. The infant was delivered following induction of labour at 38 weeks of gestation, and was at 3.8 kg, the 90th centile for gestational age, and had no neonatal morbidity. This case illustrates a successful use of GDM screening and a positive response to targeted insulin therapy.

• What evidence is there for adverse effects on the fetus of hyperglycemia in the second half of pregnancy? • What evidence is there for the modifi cation of these adverse effects by treatment aimed at reducing hyperglycemia? • What are the roles of diet therapy, insulin, and/or oral hypoglycemic agents in the control of hyperglycemia?