impact on mother

Effects on the fetus

Effects on newborns

·Have a family history of diabetes, recurrent spontaneous abortion, stillbirth or delivery of term infants with respiratory distress syndrome (RDS), delivery of macrosomia, etc., and multiple positive urine glucose tests during pregnancy, etc. The age of onset is >30 years old, the maternal weight is >90kg, vulvar and vaginal candidiasis is common, the fetus is too large or polyhydramnios is present in this pregnancy.

1. Blood glucose measurement: Those with fasting blood glucose ≥5.8mmo1/L 2 or more times can be diagnosed as diabetes. 2. Sugar screening test: 50g of glucose powder, dissolved in 200m1 of water, consumed within 5 minutes. If the blood sugar value measured 1 hour later is ≥7.8mmo1/L, the sugar screening is abnormal. Pregnant women whose 50g glucose test is ≥11.2mmo1/L are most likely to have GDM. 3. Glucose tolerance test (OGTT): refers to taking 75g of glucose orally after 1 hour of fasting. The diagnostic criteria are: fasting blood glucose 5.6mmo1/L; blood glucose 1 hour after abdominal glucose is 10.3mmo1/L; 2h 8.6mmo1/L, 3 h 6.7mmol/L, of which 2 or more items reach or exceed the normal value, it can be diagnosed as gestational diabetes. Only one item was higher than the normal value, and it was diagnosed as abnormal glucose tolerance.

Intensive medical diabetes treatment and obstetric monitoring

Goal: Lower blood sugar as much as possible and control it within normal or close to normal range

specific measure

Risk of infection: associated with reduced resistance to infection in diabetes Anxiety: related to worries about physical condition and fetal prognosis Lack of knowledge: lack of knowledge about diabetes, dietary control, and insulin use There is a risk of injury (fetus): macrosomia and malformations caused by diabetes Fetal alveolar surfactant deficiency is related to Potential complications: hypoglycemia, postpartum hemorrhage

1. Pregnant women do not get infected 2. Pregnant women complain of reduced anxiety 3. Pregnant women can recite diabetes knowledge, diet control and insulin usage 4. The fetus is not injured 5. Maternal hypoglycemia and postpartum hemorrhage do not occur

Pregnancy

1. Understand whether pregnant women have a family history of diabetes, disease history, especially unexplained stillbirths, stillbirths, macrosomia, deformities and other birth histories. 2. Understand whether pregnant women have symptoms of diabetes and their complications, as well as obstetric complications of diabetes, such as hypoglycemia, hyperglycemia, ketoacidosis, gestational hypertension, polyhydramnios, premature rupture of membranes, and infection. 3. Assess fetal health status including uterine fundal height and abdominal circumference, NST, fetal movement count, and B-ultrasound examination results. 4. Understand the monitoring results of auxiliary examinations such as blood sugar, urine sugar, and glucose tolerance tests. 5. Evaluate pregnant women’s understanding of gestational diabetes, their understanding of examination and treatment, and the response of pregnant women and their families to diabetes and treatment.