Fetal complications 2/2 DM Flashcards
What is the ideal fasting blood glucose level to avoid adverse effects of gestational diabetes?
Above 95 mg/dL
What additional risks does poorly controlled gestational diabetes mellitus pose for the infant?
Macrosomia, hypocalcemia, hypoglycemia, hyperviscosity due to polycythemia, respiratory difficulties
List the complications that can arise from maternal hyperglycemia during the first trimester.
- Neural tube defects
- Sirenomelia (fusion of limbs)
- Congenital heart disease
- Small left colon syndrome
- Spontaneous abortion
What is a complication associated with maternal hyperglycemia during the second and thrid trimesters?
fetal hyperglycemia and hyperinsulinemia
Maternal hyperglycemia can lead to various complications in the fetus.
What is the term for increased erythropoiesis in response to fetal hypoxemia?
Polycythemia, this results from increased metabolic demands seen in fetal hyperglycemia and hyperinsulinemia.
Polycythemia occurs when there’s an increase in red blood cell mass, often due to low oxygen levels.
What is a possible outcome of fetal hyperglycemia and hyperinsulinemia?
Macrosomia
Macrosomia refers to a larger than average fetal size, often due to increased insulin levels.
What conditions result from fetal Macrosomia?
Shoulder dystocia, leading to shoulder dystocia, brachial plexopathy, and perinatal asphyxia.
True or False: Maternal diabetes can lead to perinatal asphyxia.
True
Perinatal asphyxia can occur due to various complications associated with maternal diabetes.
What is a skeletal complication that can arise during delivery of an infant with maternal diabetes?
Clavicle fracture
Clavicle fractures can occur during delivery, particularly in cases of macrosomia.
What cardiac condition may develop in infants of mothers with diabetes?
Hypertrophic cardiomyopathy due to increased glycogen synthesis, leading to glycogen deposition in the interventricular septum. This condition usually reverses with glycemic control.
Hypertrophic cardiomyopathy is characterized by the thickening of the heart muscle, often related to fetal hyperinsulinemia.
What causes fetal hyperinsulinemia that leads to transient hypertrophic cardiomyopathy?
Maternal and fetal hyperglycemia
Fill in the blank: Transient hypertrophic cardiomyopathy is caused by fetal _______ in response to maternal and fetal hyperglycemia.
hyperinsulinemia
What is a consequence of insulin in the context of transient hypertrophic cardiomyopathy?
Glycogen synthesis
Does transient hypertrophic cardiomyopathy always require treatment?
No treatment is required if the patient is asymptomatic.
What can occur if left ventricular outflow is obstructed in infants?
Congestive heart failure manifestations
What are the manifestations of congestive heart failure in infants?
Respiratory distress, tachycardia, hypoxia, failure to thrive
What is the treatment for transient hypertrophic cardiomyopathy in infants if heart failure occurs?
Propranolol and IV fluids.
When does transient hypertrophic cardiomyopathy typically occur during pregnancy?
Late second to early third trimesters
Where is excess glycogen and fat deposited in the myocardium in transient hypertrophic cardiomyopathy?
Interventricular septum
What may contribute to the selective thickening of the interventricular septum?
Increased oxidative stress
Is a hypertrophic interventricular septum usually symptomatic?
No, it is usually asymptomatic
Can crackles be auscultated in infants with pulmonary edema due to transient hypertrophic cardiomyopathy?
No, crackles may not be auscultated
What might be evident on a chest radiograph in cases of transient hypertrophic cardiomyopathy?
Pulmonary congestion and cardiomegaly
What diagnostic tool confirms the diagnosis of transient hypertrophic cardiomyopathy?
Echocardiography
What common cause of tachypnea in newborns is mentioned as a differential diagnosis?
Transient tachypnea of the newborn
