pregnancy Flashcards
what hormone is produced if implantation occurs in pregnancy
HCG
-pregnancy test
what hormone is produced by the corpus luteum
progesterone
what hormones are produced by the placenta
- human placental lactogen
- placental progesterone
- placental oestrogen
what happens if there is insulin resistance in mothers
raised blood glucose then gestational diabetes
what are the three types of diabetes in pregnancy
- type 1
- type 2
- gestational
when do foetal organs start to develop
at 5 weeks or even earlier
complications associated with diabetes in pregnancy
- congenital malformation
- prematurity
- intra-uterine growth retardation
GDM
- macrosomia (big baby)
- polyhydramnios
- intrauterine death
complications in the neonate
- respiratory distress
- hypoglycaemia
- hypocalcaemia
how does maternal diabetes cause macrosomia
- maternal hyperglycaemia causes foetal hyperglycaemia
- this then causes foetal hyperinsulinaemia
- in third trimester foetus produces own insulin which is a major growth factor
management for type 1 and 2 maternal diabetes
- pre pregnancy counseling
- folic acid 5mg 3 months prior to pregnancy
- consider change from tablets to insulin
- regular eye checks
- avoid ACEI and statin
- start aspirin 150mg at 12 weeks
management for all diabetic pregnancys
-diabetic diet
-tight blood glucose controls
(pre meal <4-5.5, 2hr post meal <6-6.5mmol/l)
-continuous glucose monitoring
-monitor HbA1c
-monitor BP
-IV insulin and IV dextrose during labour
what drugs needed during type 1 pregnancy
insulin
what drugs needed during type 2 pregnancy
- metformin
- insulin later
what drugs needed for GDM
- lifestyle
- metformin
- maybe insulin
what should be done 6 weeks after GDM
post natal fasting glucose to ensure its gone or not turned into type 2
