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Gestational Diabetes Insulin Management Intrapartum


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81. Normal and Abnormal Puerperium (Diagnosis)

. These individuals should be appropriately counselled on lifestyle interventions or medical management options (i.e. metformin, insulin) to optimize their glycemic control. Those who have a normal postpartum glucose tolerance test should be appropriately counselled that there is still a 7 fold risk of developing type 2 diabetes later in life and up to 50% of women with GDM will develop diabetes over 20 years after her pregnancy. [ ] Therefore the American Diabetes Association (ADA) recommends patients with GDM (...) scheduled for a routine comprehensive postpartum evaluation between 4 to 6 weeks after delivery. Earlier postpartum follow-up is recommended in women at high risk of postpartum complications who require problem-oriented visits for closer management of hypertensive issues, postpartum depression, wound infections, lactation difficulties, or comorbidities that require postpartum medication changes (i.e. seizure disorder, diabetes). [ ] The postpartum visit is also an important time to identify


82. Pediatrics, Hypoglycemia (Treatment)

Neonatal Med . 2016 Jul 17. 1-16. . Yamamoto JM, Kallas-Koeman MM, Butalia S, Lodha AK, Donovan LE. Large-for-Gestational-Age Neonate Predicts a 2.5-Fold Increased Odds of Neonatal Hypoglycemia in Women with Type 1 Diabetes. Diabetes Metab Res Rev . 2016 May 17. . Raghuveer TS, Garg U, Graf WD. Inborn errors of metabolism in infancy and early childhood: an update. Am Fam Physician . 2006 Jun 1. 73(11):1981-90. . Ishiguro A, Namai Y, Ito YM. Managing "healthy" late preterm infants. Pediatr Int . 2009 (...) Nov. 161(5):787-91. . Narchi H, Skinner A, Williams B. Small for gestational age neonates--are we missing some by only using standard population growth standards and does it matter?. J Matern Fetal Neonatal Med . 2010 Jan. 23(1):48-54. . Vanhaltren K, Malhotra A. Characteristics of infants at risk of hypoglycaemia secondary to being 'infant of a diabetic mother'. J Pediatr Endocrinol Metab . 2013 May 17. 1-5. . Rozance PJ, Hay WW Jr. New approaches to management of neonatal hypoglycemia. Matern

2014 eMedicine Emergency Medicine

83. Pediatrics, Hypoglycemia (Overview)

population growth standards and does it matter?. J Matern Fetal Neonatal Med . 2010 Jan. 23(1):48-54. . Vanhaltren K, Malhotra A. Characteristics of infants at risk of hypoglycaemia secondary to being 'infant of a diabetic mother'. J Pediatr Endocrinol Metab . 2013 May 17. 1-5. . Rozance PJ, Hay WW Jr. New approaches to management of neonatal hypoglycemia. Matern Health Neonatol Perinatol . 2016. 2:3. . . Joshi T, Oldmeadow C, Attia J, Wynne K. The duration of intrapartum maternal hyperglycaemia predicts (...) , endotoxin shock, and ingestions, including of salicylates, alcohol, hypoglycemic agents, or beta-adrenergic blocking agents. Excluding insulin therapy, almost all hypoglycemia in childhood occurs during fasting. Postprandial hypoglycemia is rare in children in the absence of prior gastrointestinal (GI) surgery. Management efforts are directed toward the immediate normalization of glucose levels and the identification and treatment of the various causes. (See Treatment and Medications.) Patient education

2014 eMedicine Emergency Medicine

84. Risk Factors for Complications During Pregnancy

(for management of hypertension during pregnancy, see ). Diabetes Overt occurs in ≥ 6% of pregnancies, and gestational diabetes occurs in about 8.5% of pregnancies. Incidence is increasing as the incidence of obesity increases. Preexisting insulin -dependent diabetes increases the risk of the following: Fetal death Major fetal malformations (fetal weight > 4.5 kg) If vasculopathy is present, Insulin requirements usually increase during pregnancy. Gestational diabetes increases the risk of the following (...) : Hypertensive disorders Fetal macrosomia The need for cesarean section Gestational diabetes is routinely screened for at 24 to 28 wk and, if women have risk factors, during the 1st trimester. Risk factors include the following: Previous gestational diabetes A macrosomic infant in a previous pregnancy Family history of non- insulin –dependent diabetes Unexplained fetal losses Body mass index (BMI) > 30 kg/m 2 Certain ethnicities (eg, Mexican Americans, American Indians, Asians, Pacific Islanders) in whom

2013 Merck Manual (19th Edition)

85. Haemodynamic Effects of Oxytocin and Carbetocin

caesarean section with regional anesthesia Exclusion Criteria: ---Women with placenta praevia placental abruption multiple gestation pregnancy related complications and disorders (i.e. preeclampsia, gestational diabetes) pre-existing diseases (e.g. insulin-dependent diabetes, cardiovascular or renal diseases, thyroid disease taking medication with known impact on the cardiovascular system undergoing caesarean section with general anesthesia secondary caesarean section Contacts and Locations Go (...) Haemodynamic Effects of Oxytocin and Carbetocin Haemodynamic Effects of Oxytocin and Carbetocin - Full Text View - Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Haemodynamic Effects of Oxytocin and Carbetocin The safety

2011 Clinical Trials

86. Antenatal care for uncomplicated pregnancies

salads, before eating thoroughly cooking raw meats and ready-prepared chilled meals wearing gloves and thoroughly washing hands after handling soil and gardening avoiding cat faeces in cat litter or in soil. Antenatal care for uncomplicated pregnancies (CG62) © NICE 2019. All rights reserved. Subject to Notice of rights ( conditions#notice-of-rights). Page 27 of 471.9 Screening for clinical conditions 1.9.1 1.9.1 Gestational diabetes Gestational diabetes For guidance (...) care 6 Key priorities for implementation 7 1 Guidance 9 1.1 Woman-centred care and informed decision-making 9 1.2 Provision and organisation of care 12 1.3 Lifestyle considerations 13 1.4 Management of common symptoms of pregnancy 18 1.5 Clinical examination of pregnant women 20 1.6 Screening for haematological conditions 21 1.7 Screening for fetal anomalies 23 1.8 Screening for infections 25 1.9 Screening for clinical conditions 28 1.10 Fetal growth and well-being 30 1.11 Management of specific

2008 National Institute for Health and Clinical Excellence - Clinical Guidelines

87. Hypertension in Pregnancy

of pregnancies than in the non-hypertensive cohort. By instituting the standardized protocol proposed within this guideline for the assessment, surveillance, and management of all women admitted to a BC healthcare facility with a HDP, the TESS project is anticipated to improve maternal and neonatal outcomes in BC. 3. ri Sk FA c Tor S • Family history • extremes of reproductive age • Primigravida • Multiple gestationDiabetes, renal disease, hypertension prior to pregnancy • Collagen vascular disease (...) renal disease or diabetes • sBP >140 mmHg or dBP >90 mmHg n Recommended treatment of non-severe hypertension in pregnancy • Treatment goal: dBP 80-105 mmHg (depending on practitioner preference) o First choice agent: Methyldopa (Aldomet) o second choice agents: Labetalol (Trandate); Nifedipine (Adalat PA or XL) o special indications (renal or cardiac diseases): diuretics • Drugs to avoid: angiotensin-converting enzyme inhibitors; angiotensin II receptor antagonists; atenolol n Acute management

2006 British Columbia Perinatal Health Program

88. Diabetes in Pregnancy

and Child Health (CEMACH), February 2007 ; Management of Type 1 Diabetes in Pregnancy. Curr Diab Rep. 2016 Aug16(8):76. doi: 10.1007/s11892-016-0765-z. ; NICE Clinical Guideline (November 2014) ; NICE Clinical Guideline (March 2008, updated 2018) ; Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes. Cochrane Database Syst Rev. 2016 Jun 7(6):CD005542. doi: 10.1002/14651858.CD005542.pub3. ; NICE Clinical Guideline (August 2010, updated (...) Guidelines. You may find the article more useful, or one of our other . In this article In This Article Diabetes in Pregnancy In this article This article deals with pregnancy in patients with pre-existing diabetes. See also separate article. Epidemiology Diabetes is the most common pre-existing medical disorder complicating pregnancy in the UK. Up to 5% of women giving birth in England and Wales have either pre-existing diabetes or gestational diabetes [ ] . The number of people with type 1 diabetes

2008 Mentor

89. Gestational Diabetes

outcomes in women undergoing bariatric surgery: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2014 Oct181:45-53. doi: 10.1016/j.ejogrb.2014.07.015. Epub 2014 Jul 30. ; Diabetes UK ; Gestational diabetes mellitus: insulinic management. J Obstet Gynaecol India. 2014 Apr64(2):82-90. doi: 10.1007/s13224-014-0525-4. Epub 2014 Mar 18. ; Effect of treatment of gestational diabetes mellitus: a systematic review and meta-analysis. PLoS One. 2014 Mar 219(3):e92485. doi: 10.1371 (...) Gestational Diabetes Gestational Diabetes information. Diabetes in pregnancy | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Gestational Diabetes Authored by , Reviewed by | Last edited 2 Dec 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European

2008 Mentor

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