Mandatory medical device diagnostics.
- Ultrasound diagnostics in pregnancy should be routinely performed (see also under “Further notes”)[including determining whether there is an excess of the 75th percentile of fetal abdominal circumference/abdominal circumference (AU) (= morphologic substrate of excessive fetal (“infantile”) insulin secretion]
- Pregnant women who have previously undergone gestational diabetes should be advised of the need to perform sonographic examination of fetal nuchal translucency (NT) at 11-14 weeks of gestation
- Differential organ diagnosis should be performed at 19-22 weeks of gestation in pregnant women diagnosed with gestational diabetes before 24 weeks of gestation and with additional risk factors present
- In the third trimester (third trimester of pregnancy), biometry should be performed regularly at short intervals to assess fetal growth patterns (esp: ATD abdominal transverse diameter (external-external)/abdominal diameter, measured transversely).
- In gestational diabetes with insulin therapy, CTG checks are indicated from 32 weeks of gestation.
Further notes
- An Australian Cochrane group concludes the following on the topic of exceeding the 75th percentile of fetal abdominal circumference (AU):Additional fetal biometry (“fetal measurement by ultrasound“) compared with blood glucose self-monitoring (SMBG) alone had no statistically significant effect on relevant maternal, fetal, and neonatal outcomes.
