Diabetic fetopaty

Question 1

clinica (presente sia nel diabete mellito gestazionale che pregestazionale)

Answer 1

Diabetic fetopathy

Effects
Macrosomia: birth weight > 90th percentile or > 4000–4500 g (due to stimulated growth and adipogenesis) → increased risk of birth injuries (e.g., shoulder dystocia)

Polycythemia (per la carenza di ossigeno)

Neonatal hypoglycemia (minore di 50 mg/dl ) and other electrolyte imbalances (hypocalcemia, hypomagnesemia)

Respiratory distress (due to insufficient production of pulmonary surfactant)

Hypertrophic cardiomyopathy (polycythemia → redistribution of iron → iron deficiency in cardiac tissue and hypoxemia → impaired cardiac remodeling)

Polyhydramnios (fetal hyperglycemia → fetal polyuria)

Question 2

Quando

Answer 2

Onset: second and third trimester

Question 3

Fisiopatologia (ipossemia fetale!!)

Answer 3

Pathophysiology: chronic fetal hyperglycemia → fetal hyperinsulinemia + islet cell hyperplasia, insulin-like growth factor, and growth hormones → ↑ metabolic effects and oxygen demand → fetal hypoxemia