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    GDM With Polyhydramnios

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    Sure Navyasri
    A 29-year-old pregnant woman, 34 weeks into her second pregnancy, presented with gestational diabetes and excessive amniotic fluid (polyhydramnios). She had been diagnosed with gestational diabetes 2 weeks prior based on an abnormal glucose tolerance test. Her first pregnancy resulted in a normal delivery. On examination, her uterus was enlarged consistent with a term pregnancy. The fetus was in a breech position with excessive amniotic fluid detected. She had been following a diabetic diet for 4 weeks.

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    GDM With Polyhydramnios

    Uploaded by

    Sure Navyasri
    90 views4 pages
    A 29-year-old pregnant woman, 34 weeks into her second pregnancy, presented with gestational diabetes and excessive amniotic fluid (polyhydramnios). She had been diagnosed with gestational diabetes 2 weeks prior based on an abnormal glucose tolerance test. Her first pregnancy resulted in a normal delivery. On examination, her uterus was enlarged consistent with a term pregnancy. The fetus was in a breech position with excessive amniotic fluid detected. She had been following a diabetic diet for 4 weeks.

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    GDM with polyhydramnios (1)

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    A 29-year-old pregnant woman, 34 weeks into her second pregnancy, presented with gestational diabetes and excessive amniotic fluid (polyhydramnios). She had been diagnosed with gestational diabetes 2 weeks prior based on an abnormal glucose tolerance test. Her first pregnancy resulted in a normal delivery. On examination, her uterus was enlarged consistent with a term pregnancy. The fetus was in a breech position with excessive amniotic fluid detected. She had been following a diabetic diet for 4 weeks.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    90 views4 pages

    GDM With Polyhydramnios

    Uploaded by

    Sure Navyasri
    A 29-year-old pregnant woman, 34 weeks into her second pregnancy, presented with gestational diabetes and excessive amniotic fluid (polyhydramnios). She had been diagnosed with gestational diabetes 2 weeks prior based on an abnormal glucose tolerance test. Her first pregnancy resulted in a normal delivery. On examination, her uterus was enlarged consistent with a term pregnancy. The fetus was in a breech position with excessive amniotic fluid detected. She had been following a diabetic diet for 4 weeks.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 4

    Gestational diabetes mellitus with Polyhydramnios

    A 29 yr old unbooked case G 2 P1 L 1 Mrs , w/o , resident of eluru,


    belonging to low socioeconomic status with regular cycles, with 8 months of
    gestational age was admitted in view of increased blood sugars & increased
    liquor
     LMP on
     EDD falls on
     Period of gestation – 32weeks 2 days
    H/O present illness
     She was diagnosed as gestational diabetes 2 weeks back with altered
    GTT values done outside and was advised diet regulation
     No H/O burning Or increased frequency of micturition
     No H/O itching of vulva.
     No H/O bleeding or leaking P/ V.
     No H/O headache, epigastric pain, blurring of vision, pedal edema.
    Obstetric history: G2 P1 L1
    1st pregnancy : conceived spontaneously with in a year of marital life.
    Antenatal period ;
     Delivered a single full term male child of birth weight 3.0kg at private
    hospital through normal delivery. labour & puerperium were
    normal.breast fed for 1 year.baby is Immunized and healthy.
    2nd Pregnancy (present pregnancy) : Conceived spontaneously 4yrs after last
    child birth. No H/O Using Contraception.
     Confirmed by UPT at private clinic at 2months of gestational age
    First Trimester:
    No H/o nausea/ vomiting.
    No H/o Burning / increased frequency of micturition.
    No H/o Spotting / Bleeding PV.
    No H/o Fever with rash.
    No H/o Radiation exposure.
    Dating scan was done.
    Took folic acid supplementation
    Second Trimester :
     Quickening felt in late 5th month of gestation.
     She took 2 doses of TT at 4th and 5th month of gestation.
     No H/o Burning / increased frequency of micturition.
     No H/o blurring vision / headache / epigastric pain.
     No H/o leaking PV / bleeding PV.
     Anomaly scan was done and normal.
     Took Iron folic acid and Calcium supplementation
    Third Trimester :
     Continued perceiving fetal movements well.
     No H/O blurring vision / headache / epigastric pain/ Pedal edema.
     No H/O burning / increased frequency of micturition
     No H/O bleeding PV/leaking P/V
     Routine antenatal scan was done and said to be normal.
     Continued taking Iron and Calcium supplementation
    Menstural H/O :Age of Menarche – 14 years
    She has regular cycles, bleeds for 3 - 5 days for every 28 – 30 days, not
    associated with clots, no pain abdomen
    Marital H/O: ML– 5 years; Non consanguinous; No H/o usage of any OCPs
    Past H/O:
    No H/O HTN / DM / B.Asthma / TB / Epilepsy/ Thyroid / Cardiac / Renal
    diseases
    No H/O previous surgeries / blood transfusions.
    Family H/o:
    No H/O HTN / DM / B.Asthma / TB / Epilepsy / Thyroid / Cardiac / Renal
    diseases .
    No H/O Twins / MR child / Congenital abnormalities.
    Personal H/o:
    Mixed diet
    Bowel & bladder – regular. Sleep & appetite – regular.
    No H/o drug / food allergies / Addictions
    DIET HISTORY :
    ▪ 8AM: 4 idly (200 cal/ 8g) + sambar (300cal / 10g) What’s
    ▪ 10AM: 1 fruit (104cal/0.6g) this gm ?
    ▪ 1PM: 1 cup rice (100cal/2g)+ vegetables (60cal/ 1g) +
    curd (67cal/3.3g) + curry dal (300cal/10g)

    ▪ 4.30PM: 4 biscuits (100cal/2g)+ 1 cup of tea (60cal/1.4g)

    ▪ 7PM: 2 Poori (480cal/ 12.2g)+ potato curry (132 cal/ 3.2g)

    ▪ 10PM: 1 cup of milk (67cal / 3.3g)

    ▪ Total calorie intake – 1970cal (1935 cal)

    ▪ Total protein intake – 57g (64.5g)

    GENERAL EXAMINATION
    No Pallor/ icterus/cyanosis/lymphadenopathy/ pedal edema
    Thyroid, Breasts & spine- normal.
    Lower palpebral conjunctiva and tongue appeared normal
    Nails, hair, oral mucosa, palate and gums and skin were normal teeth ?
    Pre-pregnancy weight- 60 kg, Height- 152cm,pre pregnancy BMI:-26kg/m2
    Current weight- 68.5kg
    Vital data:
    Temperature- 98.60 F
    Pulse rate- 90/minute, regular
    BP- 100/70 mmHg
    Respiratory rate- 20/min
    Systemic examination:
    CVS- S1, S2 heard. No murmurs
    RS- Normal vesicular breath sounds, no added sounds
    Obstetric examination :
    Inspection :
    Abdomen is globular in shape
    Umbilicus midline and everted
    Linea nigra and stria gravidarum seen
    No scars / sinuses / engorged veins
    Hernial orifices appears normal.
    Palpation – 36 weeks overdistended
    Height of uterus- term gestation (> period of gestation)
    SFH:-36 cms Abdominal Girth -100 cms
    On Fundal grip - soft, non-ballotable fetal pole felt, probably breech
    On Lateral grip-uniformly curved resistance felt on left side suggestive of fetal
    spine. Irregular knob like structures felt on right side suggestive of fetal limbs.
    On 1st Pelvic grip –hard , round, ballotable structure felt suggestive of head.
    On 2nd Pelvic grip – hands are converging suggesting that it is not engaged
    Clinically liquor appears more than normal.
    EFW - ?
    Auscultation :
    FHS heard below the umbilicus on the left side @ 148/ min, regular in rhythm
    Summary:
    A 29yr old G2P1L1 with 34 weeks Gestation with altered GTT reports with
    polyhydramnios with gestational diabetes complicating pregnancy. She is on
    diabetic diet since 4 weeks.

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