The most elaborate regimen entails a random blood glucose test during a booking visit, a screening glucose challenge test around 24–28 weeks gestation, followed by an OGTT if the tests are outside normal limits. If there is a high suspicion, a woman may be tested earlier.In the United States, most obstetricians prefer universal screening with a screening glucose challenge test. In the United Kingdom, obstetric units often rely on risk factors and a random blood glucose test. The American Diabetes Association and the Society of Obstetricians and Gynaecologists of Canada recommend routine screening unless the woman is low risk (this means the woman must be younger than 25 years and have a body mass index less than 27, with no personal, ethnic or family risk factors) The Canadian Diabetes Association and the American College of Obstetricians and Gynecologists recommend universal screening. The U.S. Preventive Services Task Force found there is insufficient evidence to recommend for or against routine screening, and a 2017 a Cochrane review found that there is not evidence to determine which screening method is best for women and their babies.Some pregnant women and careproviders choose to forgo routine screening due to the absence of risk factors, however this is not advised due to the large proportion of women who develop gestational diabetes despite having no risk factors present and the dangers to the mother and baby if gestational diabetes remains untreated.
Painful bruising syndrome (also known as "autoerythrocyte sensitization", "Gardner–Diamond syndrome", and "psychogenic purpura") is an idiopathic trauma-induced condition seen in young to middle-aged women who sometimes manifest personality disorders. : 829   It is characterized by a distinctive localized purpuric reaction occurring primarily on the legs, face and trunk, with recurring painful ecchymoses variably accompanied by syncope, nausea, vomiting, gastrointestinal and intracranial bleeding.Patients with this condition can experience frequent painful bruising around joints and muscles. Because of the rarity of the disorder, there are few methods of support in place for patients.Many patients are labelled with the stigma of having a psychological condition without this having a specifically proven link. There have been cases of painful bruising syndrome reported where there are no additional psychological disorders. This has been known to be put into remission with chemotherapy. It was characterized in 1955 by Frank Gardner and Louis Diamond.Patient may present with a history of intermittent purpura mostly precipitated by stress. See also
List of cutaneous conditions

References
Further reading
Panconesi, E., & Hautmann, G. (1995). Stress, Stigmatization and Psychosomatic Purpuras. International Angiology 14: 130–137. Yuecel, B., Kiziltan, E., & Aktan, M. (2000). Dissociative Identity Disorder Presenting With Psychogenic Purpura. Psychosomatics 41: 279–281. == External links ==