DIABETES MELLITUS DURING PREGNANCY

• Inherited metabolic disorder caused by insulin deficiency or excessive resistance to insulin.
• Gestational diabetes a diabetic manifestations occurring whenever the woman gets pregnant with eventual symptoms fading at the completion of pregnancy.
• Maternal effects: uteroplacental insufficiency, risk for dystocia, hydramnios.
• Fetal effects: Increase fetal mortality, risk for congenital abnormalities, increase hypoxia, large for gestational age infant, neonatal hypoglycemia.
• Effects on Pregnancy: high insulin resistance, changing insulin needs and difficulty controlling blood sugar, insulin shock more common.
• Presence of indications of hyperglycemia and hypoglycemia, hydramnios, infection and pre-eclampsia.
• Diagnostic Exams are: 2 hour post-prandial blood sugar; not recommended for all women during second trimester; 4-hour glucose tolerance test; FBS; and fetal test (NST, fetal activity determination, contracftions stress test); opthalmic exam.
• Main nursing diagnosis: Altered nutrition: greater than body requirements; high risk for infection.
• Nursing care should include: careful monitoring and strict dietary control, insulin requirements will be increasing in the second and third trimester in relation to human placental lactogen (HPL); infection prevention; and regular evaluation of fetal status.
• Oral hypoglycemic is contraindicated during pregnancy. Early delivery is anticipated.
• White's Classification of DM: click here to view...