Page 137 - Critical Maternity & Newborn Health Nursing

• Birth trauma.

• Hyperbilirubinaemia due to immaturity of the fetal liver

• Hyperviscosity

• Hypocalcaemia and hypomagnesaemia which may result from

decreased parathyroid hormone.

• Congenital anomalies.

Management of Gestational Diabetic Client:

A. Antenatal care:

1. Frequent antenatal visits: for maternal and fetal follow up.

2. Control of diabetes:

I. Diet: is arranged to supply 1800 calories/ day with restriction of

carbohydrates to 200 gm/ day, less fat and more proteins and vitamins.

II.Insulin therapy:

• Oral hypoglycemics are contraindicated during pregnancy, labor
and early puerperium as they are not adequate for controlling

diabetes, have teratogenic effects and may result in neonatal
hypoglycemia.

• Doses of insulin tend to increase in the first half of pregnancy, then

stabilize and finally rise in the last quarter, to be decreased again

postpartum.

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