General approach to obstetric management of uncomplicated GDM

This algorithm reflects the author's general approach to obstetric management of patients with uncomplicated gestational diabetes.

GDM: gestational diabetes mellitus.
* Patients who have suboptimal glucose control on nutritional therapy should also be started on insulin.
¶ When counseling patients, key issues to address include:

The difficulty in accurately predicting birth weight by any method.
The estimated fetal growth between ultrasound examination and delivery.
The risks of shoulder dystocia and associated complications.
The risks of a cesarean delivery in the current pregnancy.
The risks of cesarean delivery in the current pregnancy on management and outcome of future pregnancies.

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General approach to obstetric management of uncomplicated GDM