Editing Maternal and Newborn Nursing (section)

=== Other antepartum conditions ===

* '''Hyperemesis gravidarum''': intractable vomiting with weight loss above about 5 percent, dehydration, ketonuria, and electrolyte imbalance. Care is IV fluids, electrolyte correction, antiemetics, and thiamine before glucose-containing fluids in prolonged vomiting.
* '''Gestational diabetes''': target values commonly taught are fasting below 95 mg/dL, 1 hour postprandial below 140 mg/dL, and 2 hours postprandial below 120 mg/dL. Insulin is the traditional first-line pharmacologic agent because it does not cross the placenta. Insulin requirements ''rise'' through pregnancy as placental hormones create insulin resistance, then '''drop sharply immediately after the placenta is delivered''', which is when postpartum hypoglycemia occurs. Fetal and neonatal risks include macrosomia, shoulder dystocia, birth injury, neonatal hypoglycemia, hyperbilirubinemia, and respiratory distress syndrome.
* '''Anemia, infection, cardiac disease, and substance use''' all raise risk. TORCH infections (toxoplasmosis, other such as syphilis and parvovirus B19, rubella, cytomegalovirus, herpes simplex) cause congenital injury. Active genital herpes lesions at the onset of labor are an indication for cesarean birth.