Diabetes mellitus

Antenatal surveillance should be directed towards the detection and monitoring of the:

Glycemia-mediated risks of macrosomia, polyhydramnios and myocardial thickening. Monitoring is based on ultrasound scans every week from the time when the complications become apparent, which is usually after 32 weeks. If there is myocardial thickening delivery should be considered depending on gestation

Vascular-mediated risks of FGR and preeclampsia. Monitoring is the same as for other causes of FGR and is based on a combination of (a) ultrasonographic measurements of fetal growth and amniotic fluid volume, (b) Doppler of the umbilical arteries, middle cerebral artery and ductus venosus, and (c) fetal heart rate monitoring. The intensity of surveillance depends on the severity of fetal compromise and varies from once every two weeks to several times per week