High Risk Perinatal Care

Question 1

1st Trimester Changes

Answer 1

• Metabolic status is influenced by estrogen/progesterone
  > these hormones stimulate beta cells in pancreas to incr insulin production
  > incr peripheral use of glucose & liver dcrs production of glucose
  > therefore drops fasting glucose
  > risk for hypoglycemia in mom’s tht are insulin dependent

Question 2

How Does Diabetes in Pregnancy Affect the Fetus

Answer 2

• Mom’s BG incrs
• Baby’s BG incrs
• The fetus releases insulin
  > insulin allows glucose to be used & causes fat storage & incrs the size of organs
• This results in Fetal Macrosomia (big baby)

Question 3

Hormones That Increase Blood Glucose

Answer 3

• HPL (Human Placental Lactogen)
• Coritsol
  > released by adrenal gland
• GH
  > released by pituitary gland
• Progesterone
  > released by adrenal glands, ovaries, placenta
• They also cause insulin resistance to mom
• This is done so baby can have more BG

Question 4

Why does Blood Glucose Drop Post Birth

Answer 4

Estrogen & Progesterone drop after the delivery of the placenta