Pregnancy Flashcards
hormone that ovum produces
oestradiol
hormone that corpus luteum secretes
progesterone
implanted embryo secretes this hormone
hCG
hPL stands for ___
secreted by the ___
human placental lactogen
placenta
placenta secretes these three hormones
hPL
oestrogen
progesterone
__+__ (hormones) cause insulin resistance in pregnant mother if predisposed this =>
progesterones and hPL
increased bg and gestational diabetes
complications of diabetes in pregnancy
congenital malformation premature IUGR (intrauterine growth retardation - if existing T1/2D) macrosomnia (>90th centile) polyhydramnios intrauterine death
2 neonatal complications of diabetes in pregnancy
respiratory distress (immature lungs) hypoglycaemia/calcaemia (fits)
CNS defects of neonate if diabetes in pregnancy
spina bifida (risk x5) anencephaly caudal regression (x200) ereteric duplication (x20)
why does diabetes in pregnancy cause macrosomnia and neonatal hypoglycaemia?
maternal bg increased causes foetal bg to increase too
insulin therefore increases (in 3rd trimester baby produces their own) = major growth factor
definition by weight of macrosomnia in a neonate
> 4kg
if have T1/2D and become pregnant:
give ____, 3 monthly ___, avoid __+__
5mg folic acid
eye check up (accelerates retinopathy)
ACEI and statins
bp control in pregnancy can be (3)
nifedipine
methyldopa
labetolol
when in labour if diabetic then give __+__ so that the mother has ___
IV insulin and IV dextrose
good bg control
Rx for T1D during pregnancy =
insulin
Rx for T2D during pregnancy =
metformin but may go on to need insulin
Rx for MODY during pregnancy =
sulfonylureas
Rx for gestational diabetes =
lifestyle and metformin
may go on to need insulin
if have GDM the 6wk post-natal get a ___ if +ve = __
___% (80% if obese) go on to develop T2D
OGTT = T2D
50%
the demand on the thyroid increases/decreases during pregnancy?
increases
hCG acts like ___ in pregnancy and so fT4 ___, TSH ___ and causes ____
TSH
increases
decreases
hyperemesis gravidarum
hyperemesis gravidum is caused by high ___
hCG
thyroid __ in size and ___ production increases in pregnancy
increases
t4
TSH and hCG return to normal at ___ in pregnacy
20wks
if pregnant with existing hypothyroidism increase dose of levothyroxine by ____ asap
average overall dose increase = ___ by 20wks
25microg
100-150microg (50%)
aim for TSH levels in pregnant ladies with existing hypothyroidism
<3mU/l
features of hyperemesis gravidum that distinguish it from hyperthyroidism in pregnancy
hCG high causes TSH to be low
TRIg -ve
resolves by 20wks
hyperthyroid drug used in 1st trimester
PTU (and beta blocker)
Hyperthyroid drug used in 2nd/3rd trimester
carbimazole
TRIgs +ve in the third trimester can cross the placenta and cause
transient neonatal thyrotoxicosis
__% of females (___% if T1D) get postpartum thyroiditis = __>___
usually lasts ___ but can be up to ___
5% 25% hyperthyroid hypothyroid 1-4 months up to 1yr
post partum thyroiditis causes a ___ goitre
and hypo phase is associated with
small, diffuse, non-tender goitre
postpartal depression
if bg ___ then advise a diabetic not to get pregnant
> 85mmol/mol
HbA1c is less accurate in pregnancy because
increased rate of RBS turnover
IFG =
its associated predominantly with __ insulin resistance and causes ___ to increase
impaired fasting glucose
hepatic
fasting bg
IGT =
ass predominantly with ___ insulin resistance and causes ___ to increase
impaired glucose tolerance
muscle
post prandial bg
if reduced visual acuity improves by looking through a pinhole =
a refractive error
hazy cornea and fixed mid-dilated pupil =
acute glaucoma
swollen optic disk =
papilloedema
curtain drawn across one eye’s vision, no pain =
retinal detachment
