Late hyperglycemia in pregnancy is associated with:

“Hyperglycemia at the time of conception results in enhanced rates of spontaneous abortion and major congenital malformations. Hyperglycemia in later pregnancy increases the risk for macrosomia, hypocalcemia, polycythemia, respiratory difficulties, cardiomyopathy, and congestive heart failure.” COGDT 10/e, p 316 Macrosomia: Fetal macrosomia is defined by ACOG as fetal birth weight is > 4500 g. Macrosomic fetuses have extensive fat deposits on the shoulder and trunk which is associated with increased incidence of shoulder dystocia. Organ which is not affected in macrosomia is brain. Control of postparandial blood sugar levels is very important for preventing macrosomia. For diagnosing macrosomia: USG is performed every 4 weeks, starting at 20 weeks of gestation. First sign of developing macrosomia is: increase in abdominal circumference more than other measurements. Management : If wt of fetus is > 4.5 kg in diabetic mothers or > 5 kg in non diabetic mothers–section is recommended.