Diabetes in Pregnancy Flashcards

1
Q

what are the two phases of mensuration

A

follicular

luteal

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2
Q

What triggers ovulation

A

A surge in the production of LH

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3
Q

What does FSH do in the follicular phase

A

stimulated development and maturation of the follicle

stimulates oestrogen release from the ovarian tissues

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4
Q

what happens to the follicle in the luteal phase

A

it becomes the corpus luteum

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5
Q

what stimulates HCG release

A

Implantation of the corpus luteum

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6
Q

why are oestrogen and progesterone levels high in the luteal phase

A

secreted by the corpus luteum and act as negative feedback on the pituitary gland so no more follicles are developed at this time

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7
Q

what hormones does the placenta produce

A

Human placental lactogen
Placental progesterone
Placental oestrogen

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8
Q

what does prolactin do

A

stimulates further development of breast tissue to allow breast feeding an lactation??

released by the pituitary in the luteal phase

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9
Q

what can cause insulin resistance in pregnancy

A

The release of progesterone

The release of hPL from the placenta

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10
Q

what are the 3 types of diabetes seen in pregnancy

A

Type 1
Type 2
Gestational

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11
Q

when does gestational diabetes most commonly develop

A

within the last trimester as that’s when the hormones really start to increase in quantity

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12
Q

when does foetal organogenesis start

A

5 weeks or possibly earlier

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13
Q

how can high blood glucose levels cause congenital malformations

A

by disrupting foetal organogenesis

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14
Q

What are some complications that occur due to diabetes in pregnancy

A
congenital malformations 
prematurity 
Into-uterine growth retardation 
macrosomia 
Polyhydramnios 
Intrauterine death
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15
Q

what are some complications in the neonate due to diabetes

A
respiratory distress (more immature lungs) 
Hypoglycaemia 
Risk of CNS defects 
Skeletal abnormalities 
Genital and GI abnormalities
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16
Q

How do you manage type 1 and 2 diabetes in pregnancy

A
pre-pregnancy counselling 
Folic acid (5mg) 
Consider change from T2DM to insulin before pregnancy 
regular eye checks 
acoid ace inhibitors and statins 
control lifestyle 
control BG 
monitor HbA1c
Monitor BP
17
Q

how can you maintain good blood glucose control during labour

A

IV insulin

IV dextrose

18
Q

When should gestational diabetes go away after pregnancy

A

5-12 weeks

If it doesn’t go away then the patients has T2DM

19
Q

how does gestational diabetes increase your risk of getting T2DM

A

gestational diabetes is a marker of having insulin resistance meaning the patients is more likely to go on to develop T2DM

(50% will go on to develop T2DM)

20
Q

How to prevent T2DM after gestational diabetes

A
Keep weight low as possible 
Healthy diet 
Aerobic exercise
Metformin
Annual fasting glucose