Medical problems in pregnancy Flashcards
Define gestational diabetes
Carbohydrate intolerance of variable severity with onset or first presentation in pregnancy
Why is gestational diabetes thought to happen?
- Pregnancy is the state of insulin resistance
- Due to placental secretion of anti-insulin hormones like HPL, cortisol and glucagon
- Gestational diabetes is exaggerated form of this
What % of women will develop diabetes in their pregnancy
1-2%
What % of women who have gestational diabetes will go along to have overt diabetes within 10-15 years
50%
Risk factors for gestational diabetes
- Family history
- Previouso macrosomic baby
- Previous unexplained stillbirth
- Obesity
- Polyhydramnios
- LGA in current pregnancy
Name the 4 main maternal complications of gestational diabetes
1) Hyperglycaemia/ hypoglycaemia
2) Pre-eclampsia
3) Infection
4) Thromboembolic disease
4 minor complications of gestational diabetes
Nephropathy
Retinopathy
CAD
Poor wound healing
Name 4 foetal complications that may arise from gestational diabetes
Macrosomia
Resp distress syndrome
Hypoglycaemia
Hyperbilirubinaemia
In what % of women is group B streptococcus normal flora
25%
What are the complications of group B streptococcus neonatal infection
Pneumonia
Meningitis
Non-focal sepsis
Death
How can you prevent group B strep in neonates
- Oppurtunistic detection antenatally (swabs/ urine)
- Risk profilling
- Benzylpenicillin in labour
If you treat group B strep in pregnancy, will this prevent passing it onto the child during delivery
No it just comes back
What are the risks profilled for GBS infection
- Preterm ruptured membranes
- Prolonged ruptured membranes
- Previous GBS neonatal infection
- INtrapartum fever
- GBS bacteria in pregnancy
What maternal complication may arise from a urinary tract infection
Pyelonephritis (kidney infection)
What foetal complication may arise from urinary tract infection
Growth restriction
Preterm labour
How do you treat urinary tract infections
Penicillins
Cephalosporins
Nitrofurantoin
What drug, used to treat utis in non pregnant women is teratogenic
Trimethoprim
What is listeriosis
Bacterial infection- virus symptoms but can be fatal for baby
If syphilis is untreated, what is the risk of congenital syphilis
50
In syphilis the earlier the disease stage….
The worst the prognosis
How is syphilis treated
Penicilin
What are the complications of chlamydia and gonorrhoea on the mother
Endometritis
What are the complications of chlamydia and gonorrhoea on the baby
Pneumonia Ophthalmia neonatorum (form of conjuctivitis)
How do you treat chlamydia and gonorrhoea in pregnancy
Azithromycin
