Choosing Wisely:

Don’t perform antenatal testing on women with the diagnosis of gestational diabetes who are well controlled by diet alone and without other indications for testing.

Rationale and Comments: Monitoring of glucose levels and maintaining adequate glycemic control for gestational diabetes are paramount to decreasing adverse outcomes, including stillbirth. If nutritional modification and glucose monitoring alone control maternal glycemic status such that pharmacological therapy is not required, the risk of stillbirth due to uteroplacental insufficiency is not increased. Thus, the use of routine antepartum testing (e.g., biophysical profile or nonstress test) in the absence of other comorbidities is not indicated.
Sponsoring Organizations:
  • Society for Maternal-Fetal Medicine
  • Sources:
  • Retrospective cohort study
  • Disciplines:
  • Obstetrical
  • References: • Rosenstein MG, Cheng YW, Snowden JM, Nicholson JM, Doss AE, Caughey AB. The risk of stillbirth and infant death stratified by gestational age in women with gestational diabetes. Am J Obstet Gynecol. 2012;206:309.e1-7.

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