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Maternal Medicine Posters
Audit of blood sugar management in diabetic pregnancies
  1. R Raghavan,
  2. L Thirumalaikumar
  1. Worcester Royal Hospital, Worcester, United Kingdom

Abstract

Background Diabetes is the commonest medical disorder affecting pregnancy in the UK, affecting 1 in 250 pregnancies. Our aim in managing diabetic pregnancies should be to achieve a pregnancy outcome that approximates to that of the non-diabetic woman.

Aims To audit the management of pre-gestational diabetic women when they receive steroids and also the management of blood sugars in the intrapartum and postpartum periods.

Study Retrospective case notes analysis for a period of six months.

We audited against our local guideline for management of women with type 1 and 2 Diabetes.

Results We had a total of 29 women who were included in the study and 6 of these needed antenatal steroids. The decision for steroid administration was appropriately taken with involvement of senior staff in all cases. All such women requiring steroids were admitted to the ward for monitoring, including sliding scale. Sliding scale was managed according to protocol in 90% of cases. We analysed all case notes and studied reasons for deviation form guideline. In the postnatal management we found lack of clear documentation of postnatal plan and no documentation of pre-and post-meal blood sugar monitoring in about half of women.

Recommendations Arrange in-patient review where appropriate and outpatient review by the diabetes team at 12 weeks postnatal for pre-pregnancy diabetes.

Discuss contraception and pre-conception planning for future.

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