Endocrinology in pregnancy Flashcards
What causes gestational diabetes?
Insulin resistance in pregnancy in predisposed mother
Name some of the complications of gestational diabetes.
Malformation Prematurity Macrosomia Neonatal respiratory distress Neonatal hypoglycaemia
How should pre-existing diabetes in pregnancy be treated?
Pre-pregnancy counselling and good sugar control
Folic acid supplements
Regular eye checks
Good BP control (avoid ACE inhibitors)
How should gestational diabetes initially be managed?
Diet modifications initally; may later require metformin
What proportion of GDM patients go on to develop T2D?
About 50%
Why are thyroid function tests in pregnancy difficult to interpret?
hCG has a TRH-like effect
What happens to the levels of thyroid-binding globulin in pregnancy and what can this cause?
Increases; patients may not be able to compensate and become hypothyroid
In patients with pre-existing hypothyroidism, what should happen to their dose of thyroxine once pregnancy is confirmed?
Increased dose and regular checks of thyroid function tests
Why can Grave’s disease sometimes improve during pregnancy?
Pregnancy suppresses autoimmunity
Which condition does post-partum thyroiditis resemble?
Hashimoto’s- 25-50% become persistently hypothyroid
How should hyperthyroidism in pregnancy be treated?
Beta-blockers early in pregnancy
Low dose anti-thyroid drugs
