Maternal Diesaes And Pregnancy: Endorcine And Metabolic Disorders Flashcards

1
Q

What are some endocrine disorders in pregnancy? 3

A
  1. Diabetes in pregnancy
  2. Thyroid disease in pregnancy
  3. Phenylketonuria (PKU)
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2
Q

Diabetes in pregnancy can be categorized how? 3

A
  1. Type 1
  2. Type 2
  3. Other (secondary)
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3
Q

What is diabetes?

A

Problem with carbohydrate metabolism leading to hyperglycaemia or high blood sugar

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4
Q

In terms of diabetes what are the ranges for spontaneous abortion?

A

15-20%

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5
Q

How many infants are born with congenital abnormalities in terms of diabetes?

A

5-10%

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6
Q

What is type1 diabetes? 2

A
  1. Autoimmune disease
  2. Immune system attacks and destroys insulin production in pancreas
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7
Q

What is diabetes type 1 also called? What is it formally called?

A
  1. Insulin dependent diabetes
  2. Juvenile onset diabetes
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8
Q

How is insulin controlled during type 1 diabetes?

A

Synthetic insulin

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9
Q

How does diabetes type 1 affect pregnancy? What will we see? 2

A
  1. Hyperglycaemia can disrupt organogenesis
  2. CARDIAC defects are most commonly seen
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10
Q

During early pregnancy diabeteic control is __________. This _________ the risk of congenital abnormalities.

A
  1. Critical
  2. Decreases
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11
Q

Besides cardia defects what do we see during diabetes type 1? 7

A
  1. Brain
  2. Blood vessels
  3. Urinary system
  4. GI tract
  5. Spine
  6. IUGR
  7. Macrosomia
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12
Q

What are some anomalies that the heart is affected by diabetes type 1? 5

A
  1. Transposition of great vessels
  2. Ventricular septal defect
  3. Atrial septal defect
  4. Coarctation of the aorta
  5. Cardiomegaly
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13
Q

What are some anomalies related to the CNS/ spine affected Diabetes type 1? 4

A
  1. Caudal regression syndrome
  2. Neural tube defect
  3. Anencephaly
  4. Microcephaly
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14
Q

What are some anomalies the urinary system is affected by diabetes? 3

A
  1. Hydronephrosis
  2. Renal agenesis
  3. Ureteral duplication
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15
Q

What are some anomalies that GI system is affected by Diabetes type 1? 3

A
  1. Duodenal atresia
  2. Anorectal atresia
  3. Small left colon syndrome
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16
Q

What are some symptoms that happen if type 1 diabetes affect the fetus later in pregnancy? 5

A
  1. Macrosomia
  2. Anoxia due to pre-eclampsia
  3. IUGR
  4. Primary fetal hazard
  5. Still birth or early neonatal death
17
Q

What is type 2 diabetes? How is it controlled?

A
  1. Change in the ability to regulate and use glucose
  2. Controlled by diet and/ or synthetic insulin
18
Q

How is type 2 developed?

A

Developed over time

19
Q

What is Gestational diabetes?

A

Developed because of pregnancy

20
Q

What are some possible complications of Type 2 Diabetes? 5

A
  1. Maternal excessive weight gain
  2. Polyhydraminos
  3. Macrocosmic infant
  4. Pre-eclampsia
  5. Fetal death
21
Q

What is the ultrasound role in GDM? 2

A
  1. Fetal assessments (BPP, Biometry, AFI)
  2. Extra views for LGA fetus
22
Q

What should the fetal subcutaneous fat measurement for LGA GDM?

A

Should be <3mm

23
Q

What is the interventricular septum thickness for LGA GDM?

A

Should be <5mm

24
Q

What should the umbilical artery cord flow be for LGA GDM?

A

Flow should be low resistance

25
Q

Hyperthyroidism affects how many causes of pregnancies?

A

0.1% - 0.4% of pregnancies

26
Q

What are some possible complications of hyperthyroidism disease for pregnancies? 6

A
  1. Thyroid storm (extreme hyperthyroidism)
  2. Pre-term birth
  3. Low birth weight
  4. Spontaneous abortion
  5. Congenital anomalies
  6. Fetal goiter
27
Q

What is hyperthyroidism conditions treated with during pregnancies?

A

Propylthiouracil (PTU)

28
Q

Is hypothyroidism common with pregnancies? Why? 3

A
  1. Rare since patient with this disorder having difficulty conceiving
  2. Maternal gonadal failure
  3. Multiple spontaneous abortion
29
Q

What is PKU stand for?

A

Phenylketonuria

30
Q

How does some get PKU?

A

Inherited autosomal recessive disease

31
Q

What is PKU? 2

A
  1. Individuals lack the gene that creates enzymes that break down phenylalanine
  2. Amino acid broken down from ingestion of protein
32
Q

How many infants are affected by PKU?

A

1 in 10,000 to 15,000 newborns

33
Q

Is it easy to know that you are afflicted by PKU?

A

Most women who have it know it

34
Q

Is PKU a common condition?

A

Common condition and is screened for in newborns

35
Q

If someone does not follow a low phenylalanine/ low protein diet what happens?

A

Develops potentially toxic levels of metabolic products

36
Q

Maternal dietary adjustments _____ inception are unsuccessful in preventing abnormalities in PKU.

A

After inception

37
Q

High levels of PKU can result in what? 6

A
  1. Spontaneous abortion
  2. Microcephaly
  3. Intellectual disability
  4. Congenital heart disease (CHD)
  5. Low birth weight
  6. Behavioural problems