Endocrine problems in pregnancy Flashcards

1
Q

What is the hormone measured in pregnancy tests?

A

HCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why is HCG released?

A

in response to implantation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What days of the ovarian cycle represent menstruation?

A

1-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What days of the ovarian cycle represent follicular growth?

A

4-12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What days of the ovarian cycle represent ovulation?

A

13-15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What days of the ovarian cycle represent luteal function?

A

16-28

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What hormones lead to insulin resistance in the mother?

A

human placental lactose

progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In which trimester does gestational diabetes occur?

A

3rd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What problems can pre existing diabetes have on the unborn baby?

A

congenital malformations
prematurity
intrauterine growth retardation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What problems can pre existing and gestational diabetes have on the unborn baby?

A

macrosomnia - >90th centile for size
intrauterine death
polyhydramiros - increased fluid around the baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What problems can pre existing and gestational diabetes have on the newborn baby?

A
respiratory distress
hypoglycaemia - fits
hypocalceamia - fits
caudal regression syndrome
spina bifida
CNS defects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does the foetus start to produce its own insulin?

A

3rd trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What happens in pregnancy in regard to the mothers glucose?

A

not taken up it is passed onto the baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Does insulin cross the placenta?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the managment of pre pregnancy diabetes?

A

Take folic acid 5mg
change from tablets to insulin
avoid ACEI and statins
good BG 3 months before conception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the BG targets for pre pregnancy diabetes?

A

pre prandial - <4-5.5

post prandial - <6.5-7

17
Q

What is the managment of gestational diabetes?

A

lifestyle changes
metformin
post natal: check fasting glucose or GTT - if not normal consider T2DM
if they are not obese and need insulin - consider T1DM

18
Q

What is the role of HCG?

A

increased thyroxine

suppresses TSH

19
Q

What can HCG mimic?

A

hyperthyroidism (biochemically)

20
Q

What do thyroid hormones do naturally in pregnancy?

A

increase

and increase binding to plasma proteins

21
Q

Why are sufficient thyroid hormones needed in pregnancy?

A

maternal thyroxine is important for CNS development

therefore, if on thyroid medications

22
Q

What are the complications of untreated hypothyroidism?

A
abortion
preeclampsia
post partum haemorrhage
preterm labour
IQ 7 points lower on avg
23
Q

What does hyperthyroidism cause in pregnancy?

A
infertility
spontaneous miscarriage
still birth
increased risk of thyroid crisis
transient neonatal thyrotoxicosis
24
Q

What is the management of hyperthyroidism in prengnacy?

A

low dose anti thyroid drugs - PTU 1st trimester, carbimazole 2/3rd
B blockers

25
Can TRAb antibodies cross the placenta and cause neonatal transient hyperthyroidism?
YES
26
What is post partum thyroiditis?
small diffuse non tender goitre hypothyroid phase that is associated with post natal depression can get an exacerbation of all autoimmune conditions after pregnancy