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PP.61 What is the Appropriate Management of a Pregnant Woman with Risk Factors For Gestational Diabetes (GDM) After an Incomplete OGTT Result?
  1. F Tabassum,
  2. A Ikomi,
  3. S Kiss,
  4. R Khan
  1. Basildon & Thurrock University Hospital, Basildon, UK

Abstract

Background Severe nausea and vomiting are recognised complications of OGTT and the estimated rate of failure to complete the 75 g test protocol has been stated as 2.4%. This scenario leaves clinicians with a dilemma about further management and there are no guidelines on this subject.

Aims To analyse the management of pregnant women with risk factors for gestational diabetes whose diagnosis remains unresolved following an incomplete WHO 75 g OGTT and to relate this to outcomes.

Methods Retrospective case note reviews of incomplete OGTT cases where fasting levels were normal according to WHO criteria.

Results 17 women met the selection criteria. All the women had at least one NICE recognised risk factor for gestational diabetes, the commonest factor being relevant history in a first degree relative [58.8%]. The OGTTs were performed between 26 and 34 weeks gestation and were all incomplete due to severe nausea or vomiting. Subsequently, 53%(9/17) of the women were given dietary advice and carried out blood glucose monitoring for one week before discharged to standard antenatal care, 6%(1/17) continued monitoring for 1 month, 6% (1/17) continued monitoring till the end of the pregnancy and 35% (6/17) were discharged to standard care without any monitoring. None of the women required any further intervention on the grounds of raised glucose levels. They all proceeded to live-births and there were no adverse sequelae directly attributable to GDM.

Conclusions Limited monitoring after an incomplete “normal” OGTT in women with risk factors for GDM resulted in no significant increase in adverse sequelae.

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