UTI

Asymptomatic bacteriuria occurs in 7% of pregnant women (ranging from 2%-12%). The predisposing conditions are reduced peristalsis and dilatation of the ureters and the bladder causing incomplete emptying and stasis of urine. Since it has no symptoms and is associated with adverse birth outcome, you should refer the mother for laboratory diagnosis. Routine urine culture for all women is recommended in ANC. Once diagnosed all women with asymptomatic bacteriuria (bacteria in the urine) should be treated with appropriate antibiotics. Urine culture should be repeated to confirm cure.

Diabetes

Diabetes Mellitus (DM) is the most common medical problem occurring with the rise in the level of glucose in the blood.You have learned this in the non-communicable disease control module previously. So, here we will focus on pregnancy-related hypertension or (Gestational Diabetes Mellitus)

Gestational Diabetes (GDM or Type III Diabetes)

• This is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy.
  
• This definition applies regardless of whether or not insulin is used for treatment. "Gestational" diabetes implies that this disorder is induced by pregnancy, perhaps due to exaggerated physiologic changes in glucose metabolism. Actually, some women with gestational diabetes have previously unrecognised overt diabetes.
  
• The extra demands on the pancreatic beta cells can precipitate glucose intolerance in women whose capacity for producing insulin was only just adequate prior to pregnancy. If a mother was already diabetic before pregnancy, her insulin needs will be increased.
  

Diagnosis of gestational diabetes mellitus

The process of diagnosis of gestational diabetes involves a two-step screening and diagnostic glucose tests on patients with risk factors for gestational diabetes. Since 35-50 % of women with gestational diabetes have no risk factors, it is wise to adopt universal screening