Monitoring and Surveillance: The BPP and NST
Management of GDM involves intensive monitoring of fetal well-being, especially in the third trimester. Because GDM increases the risk of stillbirth and placental insufficiency, doctors use several standardized tests:
Non-Stress Test (NST): Monitors the fetal heart rate in response to fetal movement. A "reactive" test indicates a well-oxygenated fetus.
Biophysical Profile (BPP): An ultrasound-based assessment of four parameters: fetal breathing, movement, tone, and amniotic fluid volume.
Growth Scans: Serial ultrasounds are performed to monitor for signs of macrosomia or polyhydramnios (excessive amniotic fluid), which can occur if fetal hyperglycemia causes the fetus to over-produce urine.
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