diabetes in pregnancy Flashcards
what should be given to diabetic during pregnancy and pre conception
folic acid 5mg
why is glycosuria common in pregnancy unrelated to DM
GFR increases and tubular glucose reabsorption decreases
maternal complications DM in pregnancy
hydramnios, pre term, still birth, pre eclampsia, miscarriage
fetal complications DM in pregnancy
malformation rates higher, macrosomia, growth restriction
neonatal risks DM
hypoglycaemia, RDS, decr Ca, decr Mg, polycythaemia
which oral hypoglycaemic can be used in pregnancy
metformin
aims fasting glucose
3.5-5.9
aims post prandial (1h) glucose
7.8
what should you exclude if the patient is unwell
DKA
what HbA1c should you not be getting pregnant
> 10% as the risk of malformation is so high
what type of malformation are you at risk of
cardiac and neural tube defect, skeletal abnormalities
what does the placenta secrete that has an anti insulin effect
lactogen, progesterone, HCG, cortisol, cytokines
what is the child at more risk of
adult obesity, glucose intolerance in childhood1
scans in diabetic patient
dating, anomaly, growth scan at 34 weeks
when is delivery aimed for
elective delivery at 38 weeks
