How do I install the Pdm Delivery Timing skill?

Run npx skillmds@latest add dromlakhani/pdm-delivery-timing in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Pdm Delivery Timing safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: makes network calls. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Pdm Delivery Timing?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Pdm Delivery Timing free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Pdm Delivery Timing?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Pdm Delivery Timing by dromlakhani — Agent Skill

Name: Pdm Delivery Timing
Rating: 4.666666666666667 (3 reviews)
Author: dromlakhani

Pdm Delivery Timing

Recommends early delivery based on individualized risk assessment rather than expectant management for pregnant patients with preexisting diabetes mellitus (PDM). Consider when evaluating delivery timing in the presence of diabetes‑related complications, suboptimal glycemia, abnormal fetal growth, or maternal comorbidities that may increase perinatal risk beyond 38 weeks gestation.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Early Delivery Based on Risk Assessment in Preexisting Diabetes

STEP 1 — Gather Information

Collect maternal diabetes type and duration, history of complications (nephropathy, retinopathy, cardiovascular disease), glycemic control (HbA1c, time in range, CGM metrics), obstetric history (prior stillbirth, preterm birth), fetal assessment (ultrasound estimated fetal weight, amniotic fluid index, Doppler), maternal comorbidities (hypertension, obesity, thyroid disease), and current gestational age.

STEP 2 — Rule In / Rule Out

Is there any high‑risk feature present (e.g., prior perinatal loss, hypertensive disorder, nephropathy, fetal growth abnormality, persistent hyperglycemia despite therapy)? If yes → proceed to risk stratification; if no → continue expectant management with weekly review.

STEP 3 — Classify or Stratify

Stratify risk into high (any major complication or poor glycemia) versus low (no complications, glycemia within target, normal fetal growth). High risk suggests consideration of delivery between 37+0 and 38+6 weeks; low risk permits expectant management up to 39+0 weeks.

STEP 4 — Decide

For high‑risk patients, schedule delivery at the earliest gestational age deemed safe based on individual risk factors (typically 37–38 weeks) after confirming fetal lung maturity if <39 weeks; for low‑risk patients, continue expectant management with weekly antenatal testing and reassess at each visit.

Clinical Guardrails / Mimics / Pitfalls

Do not deliver before 37 weeks without clear obstetric indication; avoid expectant management beyond 38 weeks in the presence of any high‑risk factor; do not rely solely on gestational age without risk assessment; do not use a single 24‑hour CGM target <140 mg/dL as a surrogate for comprehensive risk evaluation; and remember that even ideal glycemic control does not eliminate the need for risk‑based timing.

Concrete Clinical Example

A 34‑year‑old with type 2 diabetes for 10 years, HbA1c 7.2%, mild diabetic nephropathy, and ultrasound showing fetal abdominal circumference at the 90th percentile is classified as high risk; delivery is planned at 38 weeks after corticosteroid administration for fetal lung maturity.

Source: Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline, Endocrine Society/European Society of Endocrinology, 2025, https://doi.org/10.1210/clinem/dgaf288

---name: pdm-delivery-timingdescription: Recommends early delivery based on individualized risk assessment rather than expectant management for pregnant patients with preexisting diabetes mellitus (PDM). Consider when evaluating delivery timing in the presence of diabetes‑related complications, suboptimal glycemia, abnormal fetal growth, or maternal comorbidities that may increase perinatal risk beyond 38 weeks gestation.---# Early Delivery Based on Risk Assessment in Preexisting Diabetes## STEP 1 — Gather InformationCollect maternal diabetes type and duration, history of complications (nephropathy, retinopathy, cardiovascular disease), glycemic control (HbA1c, time in range, CGM metrics), obstetric history (prior stillbirth, preterm birth), fetal assessment (ultrasound estimated fetal weight, amniotic fluid index, Doppler), maternal comorbidities (hypertension, obesity, thyroid disease), and current gestational age.## STEP 2 — Rule In / Rule OutIs there any high‑risk feature present (e.g., prior perinatal loss, hypertensive disorder, nephropathy, fetal growth abnormality, persistent hyperglycemia despite therapy)? If yes → proceed to risk stratification; if no → continue expectant management with weekly review.## STEP 3 — Classify or StratifyStratify risk into high (any major complication or poor glycemia) versus low (no complications, glycemia within target, normal fetal growth). High risk suggests consideration of delivery between 37+0 and 38+6 weeks; low risk permits expectant management up to 39+0 weeks.## STEP 4 — DecideFor high‑risk patients, schedule delivery at the earliest gestational age deemed safe based on individual risk factors (typically 37–38 weeks) after confirming fetal lung maturity if <39 weeks; for low‑risk patients, continue expectant management with weekly antenatal testing and reassess at each visit.## Clinical Guardrails / Mimics / PitfallsDo not deliver before 37 weeks without clear obstetric indication; avoid expectant management beyond 38 weeks in the presence of any high‑risk factor; do not rely solely on gestational age without risk assessment; do not use a single 24‑hour CGM target <140 mg/dL as a surrogate for comprehensive risk evaluation; and remember that even ideal glycemic control does not eliminate the need for risk‑based timing.## Concrete Clinical ExampleA 34‑year‑old with type 2 diabetes for 10 years, HbA1c 7.2%, mild diabetic nephropathy, and ultrasound showing fetal abdominal circumference at the 90th percentile is classified as high risk; delivery is planned at 38 weeks after corticosteroid administration for fetal lung maturity.**Source:** Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline, Endocrine Society/European Society of Endocrinology, 2025, https://doi.org/10.1210/clinem/dgaf288

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