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Tx of palpatations

Fatigue is an early sign of decompensation

Progression of symptoms is the key to assessing decompensation

Sleep 8-10 hours/day and frequent rest periods during the day

Take cardiac meds as prescribed

Heperan for coag problems

Abx for the prevention of rhuematic fever

Visit q 2 weeks 1rst ½ pg

Especially important at 28-30 weeks!!

Then q week

If cardiac reserves are low could be fatal to mom and babe

Babe can only get glucose from Mom

Mom at risk 1rst tri for hypoglycemia

Human placental lactogen (HPL) is a polypeptide produced during pregnancy is an insulin antagonist-low at begining

Increase ketones=increase acidic environment

Shoulder Dystocia

Possibly due to excessive fetal urination because of hyperglycemia

Book mentions ADA doesn’t recommend routine….test for average risk

25 or older

Obese

Family hx

Ethnic groups

Hx abn gluc tolerance

Hx of poor outcome

2 values = or > =GD

Fasting and post prandial