Endocrinology of Pregnancy Flashcards
what is oestradiol made from?
cholesterol
what day of the menstrual cycle is luteinizing hormone at its peak?
14
what is the relationship between oestradiol and follicular growth?
once the ovarian follicle is fully grown, oestradiol is released
what happens to the follicle after ovulation?
forms a corpus luteum that produces progesterone
what hormone is measured using a pregnancy test?
human chorionic gonadotropin
what is HCG released by?
cells in the placenta
main role of HCG?
to nourish and protect the newly fertilised egg that has implanted on the uterine wall
what hormones are released by the placenta?
HCG
human placental lactogen
placental progesterone
placental oestrogens
what hormone involved in pregnancy is produced by the pituitary gland?
prolactin
name the gonadotrophic hormones
luteinizing hormone
follicle stimulating hormone
name the ovarian hormones?
oestrogen
inhibin
progesterone
name the 3 phases of the menstrual cycle in order
follicular phase
ovulation
luteal phase
after how many weeks of pregnancy can gestational diabetes be diagnosed?
24-28 weeks of high blood glucose
what is macrosomia?
birth weight over 4kg
in what trimester does the foetus start making its own insulin?
3rd trimester
what folic acid dose is given to mothers with diabetes?
5mg
what drugs should be avoided in diabetic pregnant women?
ACEi
statin
what drug can be used instead of an ACEi in diabetic mothers
labetalol
how is good blood glucose during labour?
IV insulin
IV dextrose
drug treatment for pregnant mothers who have MODY?
glibenclamide
drug treatment for gestational diabetes?
metformin
when should GTT be done post natally?
6 weeks
how likely are obese people with gestational diabetes to get type 2?
80%
what kind of cycle does hypo and hyperthyroid disease cause?
anovulatory
how is thyroid demand increased in pregnancy?
increase in size
increase in T4 production
what pregnancy hormonesi increase thyroxine production?
TSH
hCG
what is the effect of increased thyroxine in pregnancy?
suppressed TSH
how should you treat pregnant mothers with hypothyroidism?
increase thyroxine dose by 25mcg
what TSH level should you aim for in pregnant mothers with hypothyroidism?
<3mU/l
risks of untreated hypothyroidism in pregnancy?
increased abortion preeclamspsia abruption postpartum haemorrhage preterm labour
risks of untreated hyperthyroidism in pregnancy?
infertility
spontaneous miscarriage
stillbirth
thyroid crisis in labour
what is hyperemesis gravidarum?
hcg associated thyrotoxicosis
what effect does hyperemesis have on hCG and TSH levels?
increased hcG
decreased TSH
when should hyperemesis gravidarum resolve?
20 weeks gestation
similarities in presentation of hyperemesis and hyperthyroid?
tachycardia warm sweaty weight loss nausea/vomiting
treatment for hypothyroid in each trimester of pregnancy?
propylthiouracil - 1
carbimazole - 2/3
what trimester should TRAb antibodies ideally be checked?
third
what are TRAb tests looking for
hyperthyroid in baby
what is a significant postpartum thyroid problem that presents with a small, diffuse, non tender goitre
postpartum thyroiditis
what antithyroid drug has a risk of liver toxicity?
propylthiouracil
what antithyroid drug can cause GI abnormalities in baby?
carbimazole
