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TEALE FENNING Medical Education
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bluesky Guest
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Posted: Wed Jan 21, 2009 8:11 pm Post subject: diabetes |
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| discuss preconceptual conselling with a diabetic woman |
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Nick Raine-Fenning Course Director
Joined: 27 May 2006 Posts: 2037 Location: Nottingham
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Posted: Wed Jan 21, 2009 8:15 pm Post subject: |
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| Why don't you try and make this more RCOG-like by creating a clinical scenario and splitting the essay into sections each with a dedicated mark. |
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chinnu
Joined: 06 Jan 2009 Posts: 105 Location: KSA
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Posted: Sat Feb 28, 2009 3:47 pm Post subject: |
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Preconceptual counselling
Evaluation of glycaemic staus and advice to achieve good glycaemic control.
Adequate contraception till control is achieved.
target to achieve HbA1 C < 7.
If complicated by retinopathy and nephropathy,multidisciplinary input for adequate evaluation and optimal management.
Renal function tests,fundoscopy.
adequate weight control.
Advice on diet
General advice about rubella status,
Folic acid supplementaion (5mg ) lifestyle measures about smoking alcohol ,and recreational drugs.
Effects of diabetes on pregnancy (preterm labour,polyhydramnios,macrosomia,incresed susceptibility to infections, shoulder dystocia, operative deliveries,PPh)
Effects of pregnancy on diabetes ( risk of ketoacidosis, Incresed insulin requirement, Hypertensive dis, worsening retinopathy ,)
Fetal complications like prematurity, RDS, Birth trauma, hypoglycaemia,hyperinsulinaemia, hyperbilirubinaemia, hypocalcaemia, hypomagnasemia, polycythemia, future risk of DM. |
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chinnu
Joined: 06 Jan 2009 Posts: 105 Location: KSA
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Posted: Sun Mar 01, 2009 8:07 pm Post subject: |
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sorry I missed out the following
If found to have microalbuminuria referal to nephrologist should be done.
If HbA1C is >10 advice to delay pregnancy till control is achieved. |
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