A pregnant woman — OGTT high at 26 weeks; GDM; diet and metformin; big baby watched. GDM (screen 24–28w — OGTT: diet first; metformin/insulin if uncontrolled; monitor — growth — macrosomia; deliver — 38–39w; postpartum — OGTT — future diabetes risk): pregestational (optimize preconceptual — HbA1c <6.5; insulin — safe; folic acid — anomalies). Heart disease (rheumatic — mitral stenosis commonest — risk — mWHO; stenotic worse than regurgitant: avoid fluid overload, endocarditis prophylaxis; deliver — vaginal with assistance — avoid pushing in severe). Anemia (Hb <11 — iron deficiency commonest — IFA; severe <7 — transfusion; hookworm — albendazole 2nd trimester; PPH risk — correct). The diabetic pregnancy needs preconceptual control — HbA1c first.