Glucola Test and Group B Strep Test

Glucola Testing

At 28 weeks, a test for diabetes is administered to all patients. This involves not eating for at least 3 hours prior to the visit, then drinking a known amount of a glucose-containing solution. One hour later, a blood sugar measurement is obtained. If you pass this initial screen for diabetes, as most do, no further testing is usually necessary. If your screening value is too high, a confirmatory 3-hour glucose tolerance test is arranged.

If you have two or more abnormal blood glucose values in your 3-hour test, you are diagnosed with gestational diabetes. We will refer you to a nutritionist who will counsel you about the diet you should follow. She will also teach you how to measure your own blood sugar at home with a glucose meter. We ask you to record a daily fasting blood sugar and one other blood sugar during the day, 2 hours after one of your meals. We will also see you more frequently in the office, approximately every 2 weeks, to check on your blood sugars. Some patients are not able to manage their blood sugars with diet alone. If we see that happening, we may use medication called glyburide to help or we may need to start using insulin.

Gestational diabetes resolves with delivery. You do not need to keep checking your blood sugars after delivery (though you can if you want). We will arrange for another 2 hour test after your postpartum visit to screen you for insulin resistance/diabetes.

If you have either none or one abnormal value on your 3 hour test, you do not have gestational diabetes. However, it does suggest that you may have some degree of insulin resistance due to the pregnancy. We will give you a suggested diet to follow to maximize healthy outcomes for you and baby.

Group B Strep and Pregnancy

Group B Strep is a normal bacteria that inhabits the genital tract of up to 40% of female patients. It will cause infections in 1 to 2 pregnancies per 1,000 mothers who are untreated. Since such an infection can be devastating for a newborn, we give Group B Strep positive mothers preventative antibiotics when they are in labor in order to lessen the infection risk.

We routinely culture all obstetrical patients at 35-37 weeks. This culture involves swabbing the lower portion of the vagina with a Q-tip. If your culture is positive, you will be treated with antibiotics during labor.

In summary, Group B Strep is a normal bacteria inhabiting the lower genital tract of many patients. Although the bacteria rarely causes infection in the newborn, we treat any Group B Strep positive mothers with antibiotics during labor.