Gestational diabetes mellitus

Introduction: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The prevalence range from 1 to 14% of all pregnancies, depending on the population studied and the diagnostic tests employed. Risk assessment for GDM should be undertaken at the prenatal visit. Women with clinical characteristics of GDM should undergo glucose testing as soon as possible. If they are found not to have GDM at that initial screening, they should be retested between 24 and 28 weeks of gestation. Women of average risk should have testing undertaken at 24-28 weeks of gestation. Low risk status requires no glucose testing. Risk factors of GDM include, obesity, history of diabetes in first degree relatives, previous history of diabetes, glycosuria, history of birth with more than 4 kg still birth or malformation, polyhydamnius, age more than 25 years, member of an ethnic group with a high prevalence of diabetes, maternal low birth weight. GDM of any severity increases the risk of fetal macrosomia, neonatal hypoglycemia, heart hyperthrophy, jaundice, polycythemia, and hypocalcemia, obesity and still birth.