Class 2: Diabetes in pregnancy Flashcards
what are all the complications that could arise from fetal macrosomia
caesarian section
shoulder dystocia
trauma
preterm birth
what are some long term effects of gestational diabetes
likely to develop T2DM later in life
increased risk of GDM in future pregnancies
what is the criterial of gestational diabetes that differentiates it from pre existing DM
found after 20 weeks so its associated with onset of pregnancy
what are some risk factors of developing GDM that you didn’t know about
family HX of type 2 DM
personal hx of GDM
previous infant with a birth weight above 4kg (macrosomia)
on corticosteroids
PCOS and acanthuses nigricans
describe the pathophysiology behind gestational diabetes
basically the beta cells dont hypertrophy like they should to compensate for extra blood glucose normally created during pregnancy.
what is the 2 step approach to test for gestational DM
the should universal screening for GDM be done
24-28
what is ideal normal gestational weight gain
BMI: 18.5-24.9
25-35 pounds
what are the three meds used to manage diabetes during pregnancy
insulin (first line)
metformin (only issue is there is no long term data for this)
GLYBURIDE is an option for people who dont do well with metformin but refuse insulin
what would amniotic fluid look like with GDM
amniotic fluid will be high because there will be more urine production by the baby
when is induction considered for GDM
38-40 weeks because otherwise the baby will be too big to get out
amniotic fluid index values (view)
normal: 10-25cm
oligohydramnios: less than 5cm
polyhydramnios: over 25cm
should you take insulin during labour
no because body makes more during labour because it does
when is there a high risk for hypoglycemias with T2DM during pregnancy
during the first trimester because body produces too much insulin
what are the foil acid doses for T2DM in pregnancy
1mg for first trimester then switch to 0.4mg for the rest (per day)
