Does anyone know of any specific guidelines (UK, europe or US) for follow up of patients with preeclampsia or gestational diabetes post delivery?
In particular which patients to follow up, when to start and stop follow up, what parameters to measure and how often (e.g. 3-monthly, yearly?).
hello dear
see
1. https://www.nice.org.uk/guidance/ng3/resources/diabetes-in-pregnancy-management-from-preconception-to-the-postnatal-period-51038446021
2.https://rcpi-live-cdn.s3.amazonaws.com/wp-content/uploads/2017/02/Pre-eclampsia_Approved_120716.pdf
You can find all Irish Guidelines via the following link https://www.rcpi.ie/faculties/obstetricians-and-gynaecologists/national-clinical-guidelines-in-obstetrics-and-gynaecology/
Equally the ISSHP website is a good resource for interntional guidelines
http://www.isshp.org/guildelines/
For gestational diabetes, in the US, ACOG recommends a 2 hour Glucose Tolerance Test to be done at the 6 weeks post partum visit to screen for Type 2 Diabetes with our gestational diabetics.
Hi all, thank you very much for your help. I will have a look at those links.
Pre-eclampsia typically begins to resolve at the time of birth once the placenta is delivered; however, there are a small number of women who can continue or develop pre-eclampsia after birth. The importance of routine ongoing blood pressure monitoring is needed to identify these small number of women. In women with abnormal blood pressure values, pre-eclampsia labs are indicated. These women should be followed throughout the early postpartum period if abnormal labs are found. If elevated blood pressures continue at the 6 week visit, chronic hypertension may be identified. As stated earlier, some women with GDM actually may have undiagnosed Type II DM. A 2 hour gtt at 6 weeks that is abnormal is indicative of Type II DM.
It should be noted that the most commonly occurring postpartum complication are postpartum mood and anxiety disorders (PMADs). Routine screening at 6 weeks is imperative. Women with any risk factors should be scheduled for an earlier visit and undergo serial screening, be given PP education on the risk of these disorders, and receive prompt treatment if identified.