A 31-year-old woman with well-controlled pre-gestational Type 2 diabetes is at 30 weeks gestation. From which gestational age should intensive fetal surveillance with non-stress testing or biophysical profile be initiated in her case?
- A From 32 to 34 weeks ✓
- B From 24 weeks
- C Only after 38 weeks
- D Surveillance is unnecessary if glycaemic control is good
Correct answer: A. From 32 to 34 weeks
Explanation
In pregestational diabetes, antepartum fetal surveillance with twice-weekly non-stress testing or biophysical profile is typically started at 32 to 34 weeks, earlier than in uncomplicated pregnancies, because of the elevated risk of stillbirth from placental insufficiency and fetal hyperinsulinaemia. Surveillance beginning only at term misses the window of greatest stillbirth risk, and even well-controlled diabetics retain enough excess risk that routine late third trimester monitoring is standard practice.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.