Diabetes in Pregnancy

Question 1

types of diabetes in pregnancy

Answer 1

type 1 DM
T2DM
GDM
MODY

Question 2

complications related to poor control

Answer 2

congenital abnormalities
miscarriage
worsening diabetes complications
PET
macrosomnia
shoulder dystocia
neonatal hypoglycaemia

Question 3

diagnosis of GDM

Answer 3

OGTT 24-28 weeks

Question 4

pre-pregnancy counselling

Answer 4

HbA1c
high dose folic acid 5mg 3months- 12th week
lifestyle advice
counselling about risks

Question 5

glycaemic targets

Answer 5

fasting 3.5-5.5mmol/l and 1 hour <7.8mmol/l (increased monitoring)

Question 6

management

Answer 6

low dose aspirin from 12 weeks
foetal anomaly scan
regular eye and renal checks
deliver early?

Question 7

when is the foetal anomaly scan done?

Answer 7

18-20 weeks

Question 8

growth scans

Answer 8

every 4 weeks from 28 weeks

Question 9

management of GDM post-natally

Answer 9

6 weeks fasting glucose test

Question 10

what is macrosomia?

Answer 10

large baby (SFH >2cm for gestational age)

Question 11

causes of macrosomia

Answer 11

wrong dates

diabetes

Question 12

risks in macrosomia

Answer 12

obstruction
shoulder dystocia
perineal trauma
PPH
maternal anxiety

Question 13

diagnosis of macrosomia

Answer 13

USS for EFW >90th centile

abdominal circumference >97th centile

Question 14

management of macrosomia

Answer 14

exclude diabetes
reassure
IOL only if danger, not licensed for macrosomia
C/S