Gestational Diabetes

Question 1

What is the main foetal nutrient?

Answer 1

Glucose

Question 2

How is glucose produced in the foetus?

Answer 2

GNG enzymes inactivated, so glucose from mother

Question 3

What are the glucose levels in early pregnancy?

Answer 3

PG low as the mother stores it

Question 4

What are the glucose levels in late pregnancy?

Answer 4

PG high as maternal insulin resistance increases and glucose sparing for the foetus

Question 5

What are the min problems of Mat Ins Resistance?

Answer 5

Leads to Gestational Diabetes –> Shoulder Dystocia and ^ risk of macrosmia

Question 6

Why and through what methods is immune system suppressed in a woman?

Answer 6

To Prevent Foetal Rejection:
1) TH2 bias observed
2) Overall immune system suppressed
3) Extra-villous trophoblast cells have modified markers.
4) Syncytiotrophoblast has no self :non-self markers and so doesn’t stimulate an immune response.

Question 7

What are the main risks of a diabetic woman in pregnancy?

Answer 7

Shoulder dystocia.
Macrosomia.
Amniotic excess - polyhydramnios.
Stillbirth.
Hypoglycaemia.
Premature labour.
Miscarriage.
Foetal abnormalities.

Question 8

What happens in women with GD when extra glucose crosses the placenta?

Answer 8

Insulin, GF and GH’s are produced -> foetal growth is stimulated and fat and glycogen are deposited.

Question 8

What happens in women with GD when extra glucose crosses the placenta?

Answer 8

Insulin, GF and GH’s are produced -> foetal growth is stimulated and fat and glycogen are deposited.