5 Endocrine Disorders Flashcards
What is the other name for Type 1 diabetes (advanced disease)?
Juvenile Diabetes
Type 1 is _____ controlled
Insulin
Concerns with Type 1 diabetes in pregnancy
Growth factos
poor vascularization to placenta
Increased resistance at placental bed
Diabetes Type 1 is a ______ abnormality
Congenital
What disrupts organogenesis
Hyperglycemia
What are the MOST COMMON DEFETS in Diabetes Type 1
Cardaic defects
What are the OTHER defects in Diabetes Type 1 (6)
Skeletal (caudal dysplasia sequence) CNS Renal GI IUGR Macrosomia
Mothers with Type 1 diabetes has a history of (4)
Spontaneous abortions
IUGR
Intrauterine deaths-stillbirths
Neonatal deaths
The most severe form of caudal regression syndrome
Sirenomelia aka Mermaid syndrome
sacral agenesis, lower thoracis spine agenesis, hypoplastic femurs, VACTERL
Type 1 diabetes and _______ intolerance is critical to control in ______ pregnancy
glucose; early
Controlling glucose in early pregnancy decreases the risk of?
congenital abnormalities
If glucose levels are elevated in later pregnancy can result in
Macrosomia Anoxia due to pre-clampsia IUGR Primary fetal hazard stillbirth
Type 2 and Gestational diabetes can be ____ or ___ controlled
Insulin or Diet
Risk Factors of Type 2 and Gestational diabetes
Polyhydramnios excessive weight gain macrocosmic infants shoulder dystocia Nerve damage pre-clampsia Fetal deaths
When is a maternal glucose screen performed?
24-28 weeks
What value of glucose is abnormal
testing for intolerance only
> 7.8 mmol/L
GCT test you’re given __mg of glucose and maternal blood is testes __ hours after
50; 1
GTT test you’re given __mg of glucose and maternal blood is testes __ hours after
100; 1, 2 & 3
When is a GTT (glucose tolerance test) warranted
if the GCT test (glucose challenge test) is over 7.8-11 mmol/L
What does it mean if the GCT test is >11.1 m mol/L
Gestational diabetes
Sonographic features in GDM
Extra views for LGA fetus
Fetal subcutaneous fat measurement should be?
< 3mm
Interventricular septum thickness should be?
< 5mm
Hyperthyroidism (from graves disease) may cause: (3)
Goiter
Spontaneous abortion
congenital anomalies
With Hypothyroidism is rare in pregnancy as these people …
cant conceive
What are 3 Hematologic Disorders?
- Rh Isoimmunization - immunie hydrops
- Sickle cell anemia
- Heterozygous Thalassemia- hydrops
What test is done for maternal management of Hemolytic disease
Coombs Test
What are 2 types of Coombs tests
- Direct
2. Indirect
What is a Direct Coombs test?
not common detects antibodies that stuck to surface of RBC (fetus cord blood)
What is an indirect coobs test
detects antibodies that are free floating in the blood
more common and test is from the mother
What are Rh- mothers given an injection of?
RhD immune globulin
When are Rh- mothers given the injection?
28-32 weeks and again after delivery (within 72 hours)
What will the injection (RhoGAM or WINRho) prevent?
antibodies forming in the mother
Other reasons to administor WINrho in Rh- patients
Spontaneous abortion (72 hours) Therapeutic abortion Ectopic pregnancy After an AMNIOCENTESIS maternal hemorrhage, vaginal bleeding in pregnancy
(never give WINRho to a Rh+ mother)
A routine ___ and ___ is performed in fetal assessments with Rh disease
BPP; biometry
With Rh disease sonography assess for (3)
Anemia
ascites (echogenic bowel)
pleural and pericardial effusion
Doppler of the ___ is performed in Rh disease
MCA
A PSV of the MCA >__m/s = ____ in the fetus
1 ; severe anemia
MCA >1 m/s would require?
a blood transfusion
Phenylketonuria (PKU) is an…?
Inherited autosomal recessive disease
The diet provides this amino acid (Phenylketonuria) is acquired through ingestion of
protein (milk, eggs and some artificial sweeteners)
Women should follow a ___ Phenylketonuria diet
low.
due to toxic levels of metabolic products
Phenylketonuria results in (6)
Microcephaly Mental retardation CHD Low birth rates Behavioural problems spontaneous abortion
What is a common infection in pregnancy
UTI’s
What can UTI’s cause
Pre-term labour
What can maternal obesity cause in mother?
Diabetes
Hypertension
What can maternal obesity have an increased incidence of in pregnancy
1 Multiples
- UTIs
- Uterine Fibroids (grow with estrogen)
What is excessive vomiting in pregnancy called?
Hyperemesis Gravidarum
What can Hyperemesis Gravidarum cause in mother
deyhydration
electrolyte imbalance
What is sonography used to rule out with Hyperemesis Gravidarum
TWINS
Trophoblasic disease
What is LUPUS
Systemic autoimmune disease that occurs when your body’s immune system attacks your own tissues and organs.
