Screening for gestational diabetes mellitus.

Gestational diabetes occurs in 3 to 6 percent of pregnancies and is associated with increased rates of macrosomia, serious birth trauma and cesarean section. Neonatal hyperbilirubinemia, hypocalcemia and hypoglycemia also occur more frequently in this disorder. Perinatal outcome is improved through the identification and management of affected women. It is therefore recommended that all pregnant women be screened for this condition at 24 to 28 weeks of gestation. In addition to plasma glucose levels, a new measurement of glycemic control--the serum fructosamine level--may prove useful in identifying and managing women with gestational diabetes.