Medical Problems in Pregnancy Flashcards
What is meant by ‘gestational diabetes’?
Carbohydrate intolerance of variable severity, with onset or first presentation in pregnancy
What is the pathogenesis behind gestational diabetes?
Pregnancy induces insulin resistance and glucose intolerance due to placental secretion of anti-insulin hormones (HPL, cortisol and glucagon)
What are risk factors for developing gestational diabetes?
Previous occurrence, family history, obesity
What are the potential complications of gestational diabetes?
Hyper/hypoglycaemia, pre-eclampsia, infection, thromboembolic disease.
What are the potential complications of pregnancy if the mother already has diabetes?
The disease control worsens which may lead to nephropathy, retinopathy, coronary artery disease and poor wound healing
How is gestational diabetes treated?
Dietary modification (reduced calories), insulin if needed, GTT 6 weeks after delivery and regular ultrasound
Why is anaemia often present in pregnancy?
The blood volume increase and this causes a physiological haemodilution as well as a reduction in haemoglobin levels as the pregnancy progresses
Why is iron-deficiency anaemia in pregnancy an issue?
It can cause increased bleeding at the time of delivery, so oral iron supplements are given
What complications can arise from maternal sickle cell anaemia in pregnancy?
Can cause crises, including pre-eclampsia, growth restriction and preterm birth
Where is group B streptococcus found in pregnant women?
In the normal gut flora in 25% of women
Why is the transmission of streptococcus B from the mother to the foetus a concern?
Infection can lead to pneumonia, meningitis, non-focal sepsis and death in the foetus
How may urinary tract infections be treated in pregnancy?
With penicillin, cephalosporins and nitrofurantoin. This is because transmission to the foetus can result in growth restriction and preterm labour
What is the difficulty with detecting listeriosis in pregnant women?
Is often asymptomatic or presents with generalised viral symptoms
How is syphilis treated?
Penicillin
What complications may chlamydia and gonorrhoea cause for the mother and baby?
Mother = Endometriosis Baby = pneumonia
