14. DIABETES IN PREGNANCY

Question 1

What is Human Placental Lactogen ?

Answer 1

Is a hormone that increases maternal lipolysis and insulin resistance to support fetal growth. Low HPL = IUGR. It is the cause of gestational diabetes.

Question 2

Maternal risks of Diabetes in Pregnancy.

Answer 2

Increases risk of hypoglycaemia, DKA< retinopathy, nephropath, infections, pre-eclampsia.

Question 3

Foetal risk of diabetes in pregnancy.

Answer 3

Miscarriage, fetal abnormalities, preterm delivery, Macrosomia, polyhydramnios, still birth, shoulder dystocia,

Question 4

What are the neonatal complications of diabetes?

Answer 4

Hypoglycemia (fetal hyperinsulinism), jaundice, respiratory distress (immature lung development) and cardiac hypertrophy

Question 5

How does Diabetes in Pregnancy lead to neonatal jaundice?

Answer 5

Fetal hyperglycemia = high RBC production = high breakdown.
Immature liver

Question 6

How do you treat a patient with GDM?

Answer 6

Diet
Metformin
Insulin if glucose not controlled on Metformin

Question 7

At what GA do diabetic patients deliver?

Answer 7

38 weeks of gestation

Question 8

How is lung maturity tested?

Answer 8

By amniocentesis = bubble test. Is a test used to check for the presence of surfactant in amniotic fluid.