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'Referral advice' recommendation details

Diabetes in pregnancy

Guidance ID NICE 'referral advice' recommendation 'Referral advice' category
CG63 Women with diabetes should be offered a renal assessment, including a measure of microalbuminuria, before discontinuing contraception. If serum creatinine is abnormal (120 micromol/litre or more) or the estimated glomerular filtration rate (eGFR) is less than 45 ml/minute/1.73 m2, referral to a nephrologist should be considered before discontinuing contraception. Time frame not specified
CG63 If renal assessment has not been undertaken in the preceding 12 months in women with pre-existing diabetes, it should be arranged at the first contact in pregnancy. If serum creatinine is abnormal (120 micromol/litre or more) or if total protein excretion exceeds 2 g/day, referral to a nephrologist should be considered (estimated glomerular filtration rate (eGFR) should not be used during pregnancy). Thromboprophylaxis should be considered for women with proteinuria above 5 g/day (macroalbuminuria). Time frame not specified
CG63 During pregnancy, women who are suspected of having diabetic ketoacidosis should be admitted immediately for level 2 critical care. immediate
CG63 Women with diabetes should be offered antenatal examination of the four-chamber view of the fetal heart and outflow tracts at 18-20 weeks. Time frame not specified
CG63 Women with diabetes who are planning to become pregnant should be offered a structured education programme as soon as possible if they have not already attended one. Health care professionals responsible for the patient's care should ensure that patients have access to pre-conception care and advice before they discontinue contraception. Time frame not specified

This page was last updated: 22 August 2012

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.