ACOG Bulletins: Obstetrics/MFM
management UPDATED ACTUAL
Questions and CORRECT Answers
Prevalence of diabetes (and gestational diabetes) in pregnancy - CORRECT ANSWER -
7%; 86% gestational
Prevalence of gestational diabetes: least common in .. - CORRECT ANSWER -
Causcasian women
Prevalence of gestational diabetes: most common in .. - CORRECT ANSWER - Hispanic,
African American, Native American, and Asian or Pacific Islander women
same risk factors seen for type 2 diabetes such as obesity and increased age
Maternal complications of gestational diabetes - CORRECT ANSWER - higher risk of
developing preeclampsia (especially above 115 fasting gluscose), undergoing a cesarean
delivery, developing diabetes (predominantly type 2 diabetes) later in life.
Fetal complications of gestational diabetes - CORRECT ANSWER - increased risk of
macrosomia, neonatal hypoglycemia, hyperbilirubinemia, shoulder dystocia, and birth trauma
Screening for most individuals who are pregnant between X weeks - CORRECT
ANSWER - 24-28 weeks
Screening earlier than 24-28 weeks in patients with the following risk factors: - CORRECT
ANSWER - overweight and obese women (BMI > 25 unless Asian Americans >23) with
additional diabetic risk factors, including those with a prior history of GDM. However, the best
test for early GDM or type 2 diabetes screening is not clear.
Overweight with additional risk factor
, -inactivity
-high risk race/ethnicity
-1st degree relative with diabetes
-previous history
-hypertension
-PCOS
-high cholesterol
-macrosomic baby previously
-A1c > 5.7
Possibly consider 75 g 2 hr testing; but not strong recommendation from ACOG
Routine glucose challenge and OGTT (oral glucose tolerance testing)at 24-28 weeks -
CORRECT ANSWER - 50-g oral glucose solution followed by a 1-hour venous glucose
determination.
Women whose glucose levels meet or exceed an institution's screening threshold then undergo a
100-g, 3-hour diagnostic OGTT.
Gestational diabetes mellitus is most often diagnosed in women who have two or more abnormal
values on the 3-hour OGTT.
Discussed range of positive threshold values for 1 hr glucose 50 g testing - CORRECT
ANSWER - 130 - 140
Depends on the institution
plasma vs serum - CORRECT ANSWER - plasma: leftover when blood has clotted
serum: leftover when blood is anticoagulated
management UPDATED ACTUAL
Questions and CORRECT Answers
Prevalence of diabetes (and gestational diabetes) in pregnancy - CORRECT ANSWER -
7%; 86% gestational
Prevalence of gestational diabetes: least common in .. - CORRECT ANSWER -
Causcasian women
Prevalence of gestational diabetes: most common in .. - CORRECT ANSWER - Hispanic,
African American, Native American, and Asian or Pacific Islander women
same risk factors seen for type 2 diabetes such as obesity and increased age
Maternal complications of gestational diabetes - CORRECT ANSWER - higher risk of
developing preeclampsia (especially above 115 fasting gluscose), undergoing a cesarean
delivery, developing diabetes (predominantly type 2 diabetes) later in life.
Fetal complications of gestational diabetes - CORRECT ANSWER - increased risk of
macrosomia, neonatal hypoglycemia, hyperbilirubinemia, shoulder dystocia, and birth trauma
Screening for most individuals who are pregnant between X weeks - CORRECT
ANSWER - 24-28 weeks
Screening earlier than 24-28 weeks in patients with the following risk factors: - CORRECT
ANSWER - overweight and obese women (BMI > 25 unless Asian Americans >23) with
additional diabetic risk factors, including those with a prior history of GDM. However, the best
test for early GDM or type 2 diabetes screening is not clear.
Overweight with additional risk factor
, -inactivity
-high risk race/ethnicity
-1st degree relative with diabetes
-previous history
-hypertension
-PCOS
-high cholesterol
-macrosomic baby previously
-A1c > 5.7
Possibly consider 75 g 2 hr testing; but not strong recommendation from ACOG
Routine glucose challenge and OGTT (oral glucose tolerance testing)at 24-28 weeks -
CORRECT ANSWER - 50-g oral glucose solution followed by a 1-hour venous glucose
determination.
Women whose glucose levels meet or exceed an institution's screening threshold then undergo a
100-g, 3-hour diagnostic OGTT.
Gestational diabetes mellitus is most often diagnosed in women who have two or more abnormal
values on the 3-hour OGTT.
Discussed range of positive threshold values for 1 hr glucose 50 g testing - CORRECT
ANSWER - 130 - 140
Depends on the institution
plasma vs serum - CORRECT ANSWER - plasma: leftover when blood has clotted
serum: leftover when blood is anticoagulated
