Maternal Obesity Flashcards
How many women in Australia are overweight?
> 50%
Gain too much in preg what happens after preg?
Weight retention
Maternal obesity increases risk of
Neural tube defects
Exomphalos
Heart defects
Maternal obesity affect neural tube defect detection?
Missed in scan
Likely to be on diets
Pre preg Glucose
Less responsive to B12
Macrosomia is?
Birthweight >4kg
HTN and Maternal obesity preeclampsia?
Every increase in BMI, 8% increase in preeclampsia
VTE risk increased in Maternal obesity ?
Nope.
Maternal obesity and onset of labour?
Need more induction
Maternal obesity risk of preterm labour?
Notreally
Maternal obesity anaesthesia
Dosage
Epidural more challenging
GA- risk of death
Maternal obesity labour problems?
Poor uterine contractility
Maternal obesity c-section?
Harder, more infection, longer stays, higher cost
Maternal obesity lactation?
Less likely to commence
Less likely to continue
More likely to have late arrival
Diabetes in Pregnancy Insulin?
Pregnancy is diabetogenic
Diabetes in Pregnancy?
Glucose intolerance More insulin requirements Nephropathy Retinopathy Likely keto Likely hypos
DM1, consider what in Diabetes in Pregnancy if planning?
Laser for retinopathy in pre pregnancy
Diabetes in Pregnancy increases risk of what?
Pre-eclampsia
DM1 - POlyhydramnios
Miscarriage
Infection
Polyhydramnios increase risk of?
PPROM, premature labour
Diabetes in Pregnancy, congenital abnormality of note:
Caudal recession syndrome: small atrophic lower limb
Organs of babies Diabetes in Pregnancy?
All a bit underdeveloped
MEtofrmin safe in preg?
Apparently
Insulin S safe in Diabetes in Pregnancy
Yes
Glitazones and sulfonylurea, ACEi and statins safe in preg?
Nope
What is not safe Diabetes in Pregnancy drugs?
Statins
Sulphonylureas
Glitazones
ACEis
Diabetes in Pregnancy pre preg to do?
Optimal DM Review Meds Other autoimmune conditions such as thyroid, Coeliac Smoking More folate Weight loss
Diabetes in Pregnancy antenatal care?
Multidisciplary care
BSL Diabetes in Pregnancy target range?
- Fasting/preprandial 4.0-5.5mmol/l
- Post prandial
If decreasing insulin requirements in later preg in Diabetes in Pregnancy, what could that mean?
Placenta not functioning, need delivery
Diabetes in Pregnancy Intrapartum care risks?
Shoulder dystonia,
birth trauma
Diabetes in Pregnancy a lactation, BSLs?
Allow mild hyperglycaemia
What is Barker Hypothesis?
Look it up!
Dx of Gestational diabetes?
Fasting: >5.1moL/l or
1hr >10mmol/l
2hr >8.5mmol/l
