Case Study:
A woman presents to discuss the result of her glucose tolerance test. She is 42 years old and this is her sixth pregnancy. She has previously had three C-sections, one early miscarriage, and a termination of pregnancy. All previous diagnostic tests were normal as were her 11-14 week and anomaly ultrasound scans.
The woman is of Indian ethnic origin but was born and has always lived in the U.S. She is now 26 weeks gestation and a glucose tolerance test has been ordered.
Examination
The body mass index (BMI) is 31. Blood pressure is 146/87. The fundal height is 29 cm and the fetal heart rate is normal on auscultation.
Urinalysis: 1+ glycosuria
Glucose tolerance test (glucose drink): 185 mg/dL
2 hour glucose tolerance test: 160 mg/dL
Questions:
How would you document her obstetric history (GTPAL)?
What is the diagnosis and on what criteria can this be made?
What are the differential medical diagnoses?
Discuss the major risk factors for your
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