Pregnancy again ... Flashcards
Hormone produced in follicle growth?
Oestradiol
Hormone produced in fertilised ovum?
HCG
Hormone produced in corpus luteum?
Progesterone
Human placental lactogen
Placental progesterone
Placental oestrogen produced by what?
Placenta
Progesterones and hPL lead to what resistance in mother?
Insulin resistance
When does gestational diabetes present?
After 28 weeks
CNS defects in diabetes
Anencephaly, Spina bifida
Skeletal abnormalities in GD
Caudal regression syndrome
Genital and GI abnormalities in GD?
Ureteric duplication
Which makor growth factor is produced by foetus in the third trimester?
Insulin
What defines macrosomia?
BW>4kg
Supplement you give to diabetics in pregnancy?
Folic acid 5mg
Why do you give regular eye checks in pregnant diabetics?
Accelerated retinopathy
Which drugs should you avoid in pregnant diabetics?
ACEi’s and statins
How would you control blood pressure in pregnant diabetics?
Labetalol, nifedipine, methyldopa
Blood sugar aims? (pre-meal and post meal?)
pre-meal <7-8 mmol/l
How do you maintain good blood glucose during labour?
IV insulin and IV dextrose
Treatment for MODY?
Glibenclamide!!
When should you carry out a post natal GTT?
6 week post natal GTT to ensure resolution
How often should you carry out fasting glucose checks after someone with gestational diabetes has had a baby etc?
Annual fasting glucose
hCG in hyperemesis gravidarum?
hCG HIGH
50-60% have abnormal TSH/fT4
Hypothyroidism in pregnancy, how often should you check TFT’s?
Check TFTs montly for firs 20 weeks then 2 monthly until term
TSH aim for hypothyroidism in pregnancy?
Aim for TSH < 3mU/L
Untreated hypothyroidism risks in pregnancy?
Increased abortion, preeclampsia, abruption, postpartum haemorrhage, preterm labour,
Foetal neuropsychological development
Gestational hCG-associated Thyrotoxicosis
Hyperemesis gravidarum –> increased hCG, decreases TSH
Resolves by 20 weeks gestation
Only treat if persists >20 weeks
Hyperthyroid management in pregnancy?
beta blockers in early pregnancy
Propylthiouracil in 1st trimester
Carbimazole in 2nd/3rd trimester
Risks of hyperthyroidism in pregnancy?
Stillbirth
Spontaneous miscarriage
Thyroid crisis during labour
Neonatal thyrotoxicosis