CHAPTER 2

Question 1

a pregnancy with a pre-existing or developing condition that threatens the progression of the pregnancy, labor and delivery of a healthy term infant.

Answer 1

Risk Pregnancy

Question 2

are characteristics or circumstances of a person or group that are associated with an increased risk of developing or being affected by a morbid process.

Answer 2

Risk Factors

Question 3

a person with an increased expectation of disease or complication.

Answer 3

At-Risk Individual

Question 4

Used to describe a situation in which a mother, her fetus, or both are at higher risk for problems during pregnancy or delivery than in a typical pregnancy.

Answer 4

High Risk Pregnancy

Question 5

Personal-social factors that may put pregnancy at risk:

Answer 5

Maternal Age (below 16 y/o & above 35 y/o)
Birth interval
Weight (less than 100 lb and more than 200 pounds)
Height (less than 5 feet)
Parity

Question 6

Socio-economic factors that may put pregnancy at risk:

Answer 6

Poor diet/ nutritional deficiencies
Low income
Low educational level

Question 7

Behavioral factors that may put pregnancy at risk:

Answer 7

Maternal behavior
Smoking
Use of drugs
Use of alcohol
Intake of caffeine

Question 8

Parity: period of higher risk

Answer 8

First pregnancy

Question 9

Parity: risk of death for the mother is at its LOWEST

Answer 9

Second, Third, & Fourth Pregnancy

Question 10

Parity: risk is increased when mother is over 40 years old

Answer 10

Fifth Pregnancy

Question 11

a hereditary endocrine disorder characterized by inadequate or lack of insulin production that results in impaired glucose absorption and metabolism resulting in hyperglycemia.

Answer 11

Diabetes Mellitus

Question 12

• a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy
• The onset of glucose intolerance during pregnancy
• Formally defined as “any degree of glucose intolerance with onset or first recognition during pregnancy”

Answer 12

Gestational Diabetes Mellitus

Question 13

a state characterized by the destruction of the beta cells in the pancreas that usually leads to absolute insulin deficiency.

Answer 13

Type 1 DM

Question 14

a state that usually arises because of insulin resistance combined with a relative deficiency in the production of insulin.

Answer 14

Type 2 DM

Question 15

a condition of abnormal glucose metabolism that arises during pregnancy. Possible signal of an increased risk for type 2 diabetes later in life.

Answer 15

Gestational Diabetes

Question 16

a state between “normal” and “diabetes” in which the body is no longer using and /or secreting insulin properly.

Answer 16

Impaired glucose homeostasis

Question 17

What are the types of GDM?

Answer 17

Type A-1-diet controlled
Type A-2-diet and insulin controlled

Question 18

abnormal oral glucose tolerance test (OGTT) but normal blood glucose levels during fasting and 2 hours after meals; diet modification is sufficient to control glucose levels

Answer 18

Type A-1-diet controlled

Question 19

abnormal OGTT compounded by abnormal glucose levels during fasting and/or after meals; additional therapy with insulin or other medications is required

Answer 19

Type A-2-diet and insulin controlled

Question 20

Risk Factors in Developing GDM

Answer 20

1. Obesity
2. Age over 25 years
3. History of large babies (10 lbs or more)
4. History of unexplained fetal or perinatal loss
5. History of congenital anomalies in previous pregnancies
6. History of polycystic ovary syndrome
7. Family history of DM
8. Member of a population with a high risk for diabetes (Native American, Hispanic, Asian)

Question 21

Signs and Symptoms of GDM:

Answer 21

Hyperglycemia
Glycosuria
Polydipsia
Polyuria
Weight loss
Ketoacidosis

Question 22

pancreas does not produce enough insulin, thus glucose is unable to enter the cells & accumulates in the bloodstream resulting in _________

Answer 22

Hyperglycemia

Question 23

-when blood glucose levels goes beyond the renal threshold for sugar, glucose spills on the urine.

Answer 23

Glycosuria

Question 24

glucose attracts water so that when it is excreted in the kidney, it brings along with it large amounts of water resulting in the woman excreting large amounts of urine, a condition called ______

Answer 24

Polyuria

Question 25

the excretion of large amounts of fluid from the body leads to dehydration. An important symptom of dehydration.

Answer 25

Polydipsia

Question 26

since glucose cannot be utilized as a source of energy, the body uses its protein & fats stores in the muscles & adipose tissue resulting in _______

Answer 26

Weight loss

Question 27

breakdown of proteins & fats result to excessive formation of ketone bodies that the body cannot excrete right away causing them to accumulate.

Answer 27

Ketoacidosis

Question 28

Effects of Diabetes to the Mother:

Answer 28

1. Increased tendency to preeclampsia and eclampsia, UTI and candidiasis
2. Higher incidence of dystocia because of large infant
3. At increased risk for postpartum hemorrhage due to over distention of the uteris
4. Hydramnios
5. Maternal mortality
6. Diabetic retinopathy
7. Diabetic nephropathy
8. Preterm delivery

Question 29

Effects of Diabetes to the Infant:

Answer 29

1. Macrosomia
2. Birth injury
3. Hypoglycemia
4. Respiratory distress
5. Prematurity
6. Predisposition to diabetes mellitus later in life

Question 30

-refers to a baby that is considerably larger than normal.

Answer 30

Macrosomia

Question 31

When is 50-gram glucose challenge test conducted?

Answer 31

between 24-48 weeks gestation regardless of the time of the day and meals

Question 32

Normal level of 50-gram glucose challenge test?

Answer 32

less than 140 mg/dl

Question 33

Prerequisites for 100 gram three hour glucose tolerance test:

Answer 33

• Normal diet for 3 days before the test.
• No diuretics 10 days before.
• At least 10 hours fast.
• Test is done in the morning at rest.

Question 34

OGTT normal value for fasting

Answer 34

95 mg/dl

Question 35

OGTT normal value after 1 hr

Answer 35

180 mg/dl

Question 36

OGTT normal value after 2 hrs

Answer 36

155 mg/dl

Question 37

OGTT normal value after 3 hrs

Answer 37

140 mg/dl

Question 38

measures the amount of glucose attached to hemoglobin; used to detect the degree of hyperglycemia present; it reflects the average blood glucose level over the past 4-6 weeks; this is used in monitoring a woman with diabetes; upper normal level is 6% of the total hemoglobin.

Answer 38

Glycosylated Hemoglobin (HbA1c)

Question 39

done each trimester to detect asymptomatic UTIs as the increased glucose concentration in urine may lead to increased infection.

Answer 39

Urine culture

Question 40

done once to a woman with gestational diabetes and at each trimester for women with known diabetes because common background retinal changes that are common in diabetes such as increased exudate, dot hemorrhage and macular edema can progress or originate during pregnancy.

Answer 40

Ophthalmic Examination