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Arrange a consultation with the physician once per trimester if possible and as necessary if an abnormality is identified or suspected.Attempt to have final prenatal visit coincide with physician visit.
Women with more than one risk factor should receive screening at their first prenatal visit and if negative results occur, they should be rescreened once each trimester. It is diagnostic of GDM if the glucose level after 1 hour is ≥ 10.3 mmol/L.This is in comparison to the 1970 rate of live births.Estimates of GBS colonization rates among pregnant women range from 15-35%.There is considerable variability among diabetes experts nationally and internationally with regard to GDM screening.International and national expert organizations recommend that all women who have Aboriginal ancestry receive diabetes screening in pregnancy.The remainder of the information is only related to early-onset GBS disease.
The rate of GBS disease is now reported to be 0. live births.
Between 34 and 36 weeks, fax all prenatal documents [including ultrasound(s), laboratory results and the antenatal records] to the labour and delivery ward. Document the sharing of records in the client's chart.
Upon client discharge from the hospital after giving birth, ensure that the newborn assessment, labour and delivery summary and postpartum record for the woman and baby have been received so that informed follow-up care can be provided. Most cases of late-onset GBS disease occur in the first 3 months of age.
Also, clients with a history of poor compliance to medications and additional lifestyle issues such as variable diet or possible teratogenic substance use (for example, alcohol, tobacco, recreational nonprescription drugs) should also have their case discussed with a physician.
They will require increased dietary intake of folate-rich foods and higher daily doses of folic acid (for example, 5 mg/day) beginning at least three months before conception and continuing until 10-12 weeks post-conception, at which time they are normally switched to a multivitamin containing folic acid 0.4 mg/day.
They should also receive healthy lifestyle counselling.