Antenatal Visits - Testing and Schedule
At Every Visit:
• Gestational Age
• BP
• Maternal Weight
• Urine Protein
Blood Work 1:
• CBC
• Blood type and Rh
• Rubella
• Chlamydia and Gonorrhea
• VDRL
• HepB
• HIV
• +/- TSH, Ferritin, Parvovirus
GDM Risks: Macrosomia, Hypoglycemia, Jaundice, Preeclampsia, Stillbirth
GDM Management: diabetic diet, exercise, +/- insulin, Sugar checks QID, Early Induction
Glucose Tolerance Testing
• Glucose Challenge Test (GCT)
- Non-fasted. Ingest 50g Glucose
- BW 1 hr later
- Fail if > 7.8 mmolL
• Glucose Tolerance Test (GTT)
- Fasted.
- BW before starting
- Ingest 75 g Glucose
- BW 1 hour after
- BW 2 hour after
- GDM if ≥1 value is abnormal
- Fasting ≥5.3 mmol/L, 1 hour ≥10.6 mmol/L, 2 hours ≥9.0 mmol/L
Additional U/S If there are concerns for
• Growth
• Diabetes
• Placenta (30 weeks)
• Position (34 – 36 weeks) • Anatomy
• Fetal Well-being
GBS Testing - Vaginal and Rectal Swab
GBS+ -> 5 million units of PenG 4 hrs before birth (Clinda if allergic)
- Amy Chung, MD, MSc @AmyChung
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