Medical problems in pregnancy Flashcards
Medical Disorders in pregnancy
Gestational Diabetes Mellitus
Anaemia
Non-viral infections
Gestational Diabetes Aetiology
Pregnancy is state of insulin resistance + glucose intolerance
–> placental secretion of anti-insulin hormones (HPL, cortisol + glucagon)
Gestational diabetes is exaggerated form of this physiological condition
Gestational Diabetes incidence
1-2% women
More common in Indian + south east Asian women
Gestational Diabetes RFs
Previous GDM Obesity Glycosuria Polyhydramnios Large for gestational age in current pregnancy
Gestational Diabetes Maternal complications
Hyperglycaemia/hypoglycaemia Pre-eclampsia Infection Thromboembolic disease Nephropathy Retinopathy Coronary Artery Disease Poor wound healing
Gestational Diabetes Foetal Complications
Macrosomia (birth asphyxia + traumatic birth injury) Resp. Distress syndrome Hypoglycaemia Hyperbilirubinaemia (jaundice) Congenital abnormalities
Gestational Diabetes Management
Dietary modification - calorie reduction
Insulin if dietary modification still hasn’t managed the hyperglycaemia
Intrapartum monitoring
Ultrasound every 2 weeks to monitor foetal growth + wellbeing
GTT 6 weeks following delivery
Group B Streptococcus
Normal flora 25% of women
Harmless until labour
Most carriers don’t get/pass on, but if passed to baby can be life threatening
GBS neonatal infection
Pneumonia
Meningitis
Non-focal sepsis
Death
GBS Prevention
Opportunistic detection antenatally
Risk profiling
–> preterm ruptured membranes, prolonged ruptured membranes, previous GBS neonatal infection, intrapartum fever, GBS bacteriuria in pregnancy
Benzylpenicillin in labour
UTIs
More common in pregnancy
Mother- pyelonephritis
Foetal- growth restriction, preterm labour
UTI treatment
Penicillin
Cephalosporins
Nitrofurantoin
Trimethoprim- teratogenic
Listeriosis
Rare but can be fatal for baby
Pregnant women more likely to get it
Syphilis
If untreated, 50% risk of congenital syphilis
The earlier the stage of the disease, the worse the prognosis
Primary- Chancre
Secondary- rash
Latent- nothing
Tertiary- GPI, Tabes dorsalis, neurosyphilis
Syphilis treatment
Penicillin
