Gestational diagnosis

Delivered a baby weighing greater than 9 lb (4.09 kg) or previous diagnosis of gestational diabetes mellitus... 

TABLE 40-4. Diagnosis of Gestational Diabetes with a 100 or 75 g Glucose Load8... 

Diabetes mellitus is defined as an elevated blood glucose associated with absent or inadequate pancreatic insulin secretion, with or without concurrent impairment of insulin action. The disease states underlying the diagnosis of diabetes mellitus are now classified into four categories type 1, insulin-dependent diabetes) type 2, non-insulin-dependentdiabetes) type 3, other, and type 4, gestational diabetes mellitus (Expert Committee, 2003). 

HPI PH, a 28-year-old GIRO woman presents to labor and delivery at 36 weeks gestation with elevated blood pressures and proteinuria, and receives a diagnosis of preeclampsia. She has a mild headache, but no right upper quadrant (RUQ) pain or visual symptoms. 

Methods used for prenatal diagnosis of I,EM have differ ent requirements in terms of timing, sample collection, anc options for independent confirmation. CVS is performed at 10 to 12 weeks of gestational age, has a higher risk of fetal loss, and entails the occurrence of artifactual results caused by contamination with maternal tissue, which has made this... 

Figure 55-2 Multi-analyte approach to the prenatal diagnosis of methylmalonic acidemia (cb/C complementation group) by metabolite analysis in ceil-free supernatant of amniotic fluid collected at 16 weeks of gestational age. The symbol marks internal standards. A, Determination of total homocysteine by LC-MS/MS (selected reaction monitoring, SRM, transition m/z 136 to m/z 90 and m/z 140 to m/z 94 for the d -labeled internal standard). The concentration of total homocysteine was l5.7pmol/L (0.7 to 2.0pmol/L). B, Determination of methylmalonic acid by LC-MS/MS (SRM, transition m/z 231 to m/z 119 and m/z 234 to m/z 122 for the d3-labeled internal standard). The concentration of methylmalonic acid was 8.7pmol/L, the reference interval for 16 to 19 weeks of gestational age is 0.2 to 0.7)j,mol/L. C, Determination of propionylcarnitine by LC-MS/MS (parent of m/z 85 scan, the [M+H] ion of C3 is m/z 274, m/z 277 for the interna standard). The concentration was 5.6pmol/L (i.5 to l.8pmoi/L),the C3/C4 ratio was 6.9 (0.9 to 2.6).

Screening and Diagnosis Scheme for Gestational Diabetes Mellitus (GDM)... 

TABLE 71—1. Diagnosis of Gestational Diabetes Mellitus with a 100-g or 75-g Glucose Load... 

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