Diabetes Mellitus in Pregnancy: Classification, Aetiopathology, Diagnosis, Antenatal Care, Labour and Postnatal Care

A midwifery deck on gestational and pre-gestational diabetes: the classification, the 3 to 10% abnormal maternal glucose regulation, the risk factors, and the aetiopathology of the diabetogenic state from the oestrogen and human chorionic somatomammotropin insulin antagonists to the beta-cell response. It gives the cardinal signs, the effects on the mother, the pregnancy and the baby, and diagnosis on a fasting blood sugar above 7.8 mmol/l or a random above 11.1 mmol/l. Care runs from preconception counselling and the additions to routine antenatal care - glucose targets, urine protein testing, fetal growth and movement assessment, magnesium sulphate for preterm labour and induction at 38 weeks - through labour in hospital with two to four hourly glucose and shoulder dystocia anticipated, to neonatal and postnatal care with contraception.