Disorders of early pregnancy Flashcards
What happens to glucose during pregnancy?
There is a reduction of renal threshold for glucose and therefore there can be +glucose in the urine. (glycosuris)
Why is haem lower in pregnancy?
There is an overall increase in plasma volume. (normocytic, normochromic anaemia)
Why can blood pressure be lower in pregnancy?
There is a decrease in peripheral vascular resistance
Why can pregnant women get vulval variscosities?
Due to venous compression to the enlarging uterus- this leads to venous stasis and the formation of varicosities in dependent areas.
Why should you offer women in labour ranitidine?
Due to delayed gastric emptying
Why does glucose tolerance decrease in pregnancy?
Due to altered carbohydrate metabolism and the antagonistic effects of human placental lactogen, progesterone and cortisol.
Which level should does a fasting glucose need to be to diagnose gestational diabetes?
> 7.0mmol/L
Which level does glucose need to be in a GTT to diagnose gestational diabetes?
> 7.8mmol/L
Why is a diabetic mother at risk of polyhydraminos?
Birthweight is increased as fetal pancreatic islet cell hyperplasia leads to hyperinsulinaemia and fat deposition and this leads to an increased urine output and fat deposition.
How much folic acid should a diabetic woman take pre-conceptually?
5mg
What anti-hypertensives are used in needed in pregnancy?
Labetalol or methyldopa
In terms of aspirin, what is advised in pregnancy in mothers with diabetes?
75mg from 12 weeks
When should delivery be in a woman with diabetes?
by 39 weeks
When is C-section used?
when the babies weight exceeds 4kg
How are glucose levels maintained during labor?
Using a sliding scale of insulin and a dextrose infusion
