Diabetes in Pregnancy

Question 1

types of diabetes in pregnancy?

Answer 1

T1DM
T2DM
GDM
MODY

Question 2

diagnosis of GDM

Answer 2

OGTT at 24-28 weeks

Question 3

what should pre-pregnancy counselling involve?

Answer 3

HbA1c
high dose folic acid
lifestyle advice
counselling about risks

Question 4

what HbA1c should you avoid pregnancy?

Answer 4

> 96mmol/mol

Question 5

medication in diabetes in pregnancy?

Answer 5

aspirin from 12 weeks

Question 6

scans in diabetes in pregnancy?

Answer 6

foetal anomaly scan 18-20weeks

growth scans every 4 weeks from 28 weeks

Question 7

post-natal management of diabetes

Answer 7

fasting glucose 6-8 weeks later

Question 8

delivery timings in diabetes

Answer 8

• Metformin= 39-40 weeks
• Diet alone= 40-41 weeks
• Insulin= 38 weeks

Question 9

what is foetal macrosomnia?

Answer 9

large baby - >2cm SFH for gestational age

Question 10

causes of foetal macrosomnia?

Answer 10

wrong dates

diabetes

Question 11

increased risk in delivery when you have foetal macrosomnia

Answer 11

shoulder dystocia
obstruction
perineal trauma
PPH

Question 12

diagnosis of foetal macrosomia

Answer 12

USS EFW >90th centile

AC >97th centile

Question 13

management of macrosomnia

Answer 13

reassurance
IOL not licensed
C/S

Question 14

what is shoulder dystocia?

Answer 14

bony impaction of the foetal anterior shoulder and maternal symphysis

Question 15

presentation of shoulder dystocia?

Answer 15

head bobbing
turtle
sign

Question 16

management of shoulder dystocia?

Answer 16

call for help
evaluate episiotomy
mcrobert's
suprapubic pressure
internal rotation anterior shoulder/remove posterior arm
patient on all 4s

Question 17

risks in shoulder dystocia

Answer 17

Erb’s palsy

HIE

Question 18

timing limit of head to body delivery time?

Answer 18

<5 minutes