Pregnancy Flashcards
Describe the pattern of lutenizing hormone throughout the ovarian cycle
Peaks just before ovulation then sharply falls
What happens in stage one of the ovarian cycle?
Follicle grows and produces oestrodiol
What is stage two of the ovarian cycle?
Ovulation
What is stage three of the ovarian cycle?
Formation of corpus luteum
Which hormones do the corpus luteum produce?
Oestradiol and progesterone
In which stages are oestrogen found?
1 2 and 3
In which stages are progesterone found?
3 alone
What hormone, measurable in urine, does the fertilised ovum produce?
HCG
Which hormones do the placenta secrete?
Human placental lactogen
Placental progesterone
placental oestrogen
Which hormones can cause insulin resistance?
hPL
Progesterones
In which trimester is gestational diabetes most likely?
3rd
What complications can be present in GDM?
Macrosomia
Polyhydramnios
IU death
What complications may be present in the neonate?
If premature, respiratory distress
Hypoglycaemia
Hypocalcaemia
By how much is the risk of CNS defects increased due to GDM?
5x
Why does hypoglycaemia occur?
If mother producing too much insulin and foetus makes own insulin at 3 months then after birth, loses insulin supply.
What is the definition of macrosomia?
Heavier than 4kg/ 8 8oz
What folic acid dosage is given to pre-conception women?
5mg
What can be given for BP control?
Labetalol
Nifedipine
Methyldopa
What are some side effects of labetalol?
Postural hypotension
Tiredness
Liver damage
difficulty in micturition
What are some side effects of nifedipine?
GI disturbance
oedema
headache
What are some side effects of methyl dopa?
Depression
Liver damage- routine LFTs in first 12 weeks
Drowsiness affecting driving
xerostomia
What pre-meal blood sugar is ideal?
less than 5.5 - 6
What is given during delivery?
IV insulin
IV dextrose
Which one of the SU are appropriate for use in pregnancy?
Glibenclamide
How is the resolution of gestational diabetes tested?
Glucose tolerance test (GTT)
If a patient is already on thyroxine how much should this be increased by during pregnancy?
50%
What effect can hyperemesis have on TFT?
Lowered TSH
High fT4
How often should thyroid be checking during pregnancy in pre-existing hypothryoidism?
Every month for 20 weeks
What are the risks with untreated hypothyroidism?
Pre-eclampsia, postpartum haemorrhage, abortion.
Neurological underdevelopment
How can thyrotoxicosis occur in pregnancy?
Hyperemesis increases hCG which lowers TSH which results in high T4
What is the treatment for thyrotoxicosis?
Should resolve by 20 weeks
What are the risks involved with hyperthyroidism and pregnancy?
Infertility
Spontaneous abortion
Thyroid storm in labour
What drugs can be given to settle hyperthryoidism?
Labetalol
PTU in 1st trimester
Carbimazole in 2/3rd trimester
What is the risk with using PTU?
Liver toxicity
What are the issues around using carbimazole?
Scalp abnormalities
GI abnormalities
What are the issues with TRAb?
Can cross the placenta and cause neonatal transient hyperthryoidism
When can the patient become hypothryoid, after pregnancy?
Around 3 months
What symptom can appear with hypothyroidism?
Post natal depression
What drug can you add if become hypothryoid?
Thyroxine
