pregestational diabetes case study[1]

pregestational diabetes case study[1] - Case Study Pregnant...

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Case Study – Pregnant woman with pregestational diabetes (Lowdermilk , Perry, & Cashion, Ch. 20 ) Dana, a 23-year-old newly married woman, was diagnosed with diabetes when she was 16 years old. Her diabetes has been fairly stable for several years, although she occasionally experiences glucose control problems requiring reevaluation of her insulin dosage and diet. Dana and her husband are planning to become pregnant in about a year. 1. Explain why Dana and her husband Sam should seek preconception care as soon as possible. Preconception counseling is recommended because it is associated with less perinatal mortality and fewer anomalies. Counseling helps the couple plan for the optimal time for pregnancy, establish glycemic control before conception, and diagnose any vascular complications of diabetes. 2. Identify the maternal and fetal/newborn risks and complications associated with pregestational diabetes, especially if glucose control is not maintained within an acceptable range. Discuss the basis for each risk/complication identified. Maternal Risks: Fetal macrosomia(birthweight more than 4000 to 4500g), increased c-sections, increased operative vaginal births, higher rates of preeclampsia, preterm birth, maternal mortality. Chronic HTN, polyhydramnios (amniotic fluid in excess of 2000ml) is associated with premature ROM, onset of preterm labor, and PPH. Ketoacidosis occurs in the 2
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pregestational diabetes case study[1] - Case Study Pregnant...

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