Pregnancy 28-32 Weeks

Gestational Diabetes Screening

Gestational Diabetes is a common complication of pregnancy. This condition causes high levels glucose in the blood, due to hormone changes from the placenta. Your high blood level of glucose goes across to the fetus. Insulin, a hormone, converts glucose into energy. During pregnancy, the placenta limits the action of insulin resulting in Gestational Diabetes. Gestational Diabetes tends to go away after delivery; however, you have a 50% chance of developing the condition again with subsequent pregnancies. Our goal is to gain good sugar control before and during pregnancy, which can lower risks in pregnancy.

Risk Factors:

  • Overweight/obesity
  • Pregnancy over 35 years old
  • High blood pressure
  • High cholesterol
  • Family history of diabetes
  • Gestational Diabetes in previous pregnancy
  • Polycystic ovarian syndrome
  • History of cardiovascular disease
  • Native American, Asian, Hispanic, African American or Pacific Islander

Adverse Outcomes Resulting From High Sugar In Pregnancy:

  • Macrosomia (large baby): Too much sugar goes to the baby causing the baby to grow large
  • Preeclampsia: High blood pressure, edema (swelling from water retention) and protein in the urine
  • Hydramnios: Too much amniotic fluid in the sac surrounding the baby
  • Urinary Tract Infections
  • Respiratory Distress Syndrome: Condition that makes it difficult for the baby to breathe after birth
  • Stillbirth

Testing: 
Testing is performed between 24 to 28 weeks of pregnancy. Women with a history of Diabetes or Gestational Diabetes will be screened in the first trimester at 12 to 14 weeks of pregnancy.

  • A high sugar solution is ingested
  • Wait one hour after ingestion
  • Blood draw is done to check your blood sugar level
  • If the blood sugar level were too high (greater than 139), then a 3 hour Glucose Tolerance Test would be performed.

Treatment:

  • Endocrinology consultation
  • Perinatology consultation
  • Controlled balanced diet – Once again, you will see our Nutritionist
  • Exercise program
  • Frequent monitoring of your blood sugar levels with a glucose meter
  • Insulin, if your blood sugar cannot be controlled with diet and exercise

Monitoring During Pregnancy:Ultrasound

  • Electronic Fetal Monitoring
  • Biophysical Profile
  • Fetal Movement Counts

INSTRUCTIONS FOR ONE HOUR GLUCOSE SCREENING

  • Eat normally up to one hour before the testing (no need to fast)
  • You will ingest a bottle of 50g dextrose drink (provide by our office)
  • The drink must be ingested within 5 minutes
  • The time is noted when drink is finished
  • Blood is drawn exactly one hour from that time

 

PLEASE BRING SOMETHING WITH YOU TO EAT AFTER YOUR BLOOD IS DRAWN

Fetal Movement Counts

Fetal movement counts, also known as Kick Counts, is an at home test to help keep track of the baby’s movements. This assessment helps to monitor the baby’s activity pattern from 26 weeks of pregnancy until delivery. Keep in mind that every baby will have its normal wake and sleep pattern. A baby may sleep 20 to 40 minutes per cycle. This test should be done when the baby is most active throughout the day.

​How To Count Fetal Movement:

  • ​Within approximately 15 to 20 minutes after eating or drinking something, get into a comfortable resting position. If lying down, remain on your left side.
  • Make note of the counting start time
  • Count all movements (kicks, twists, flutters, swishes, hiccups, etc.)
  • When you have reached 10 movements, note the time again; most babies move 10 times within the hour.
  • Perform this assessment twice a day, unless otherwise specified by your physician

​Notes:

  • ​Fetal activity is increased at night and approximately 30 minutes after eating
  • If you do not count 10 movements in an hour, drink and/or eat something sweet. If there is still decreased movement, contact your physician to evaluate you and the baby.

 

If you have any questions, please call a WomanCare office that you visit. Or visit our contact page to leave us a message.
If you have a life-threatening emergency, please call 911 immediately.

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