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
