pregnancy and diabetes

Question 1

How does maternal metabolism change in early pregnancy

Answer 1

facilitated anabolism

• increased insulin sensitivity
• glucose concentration slightly lower
• increased maternal energy stores

Question 2

How does maternal metabolism change in later pregnancy

Answer 2

facilitated catabolism

• increased insulin resistance
• increased transplacental passage of nutrients—> rapid fetal growth.

Question 3

How does maternal hyperglycaemia affect the pregnancy in the first trimester

Answer 3

increased fetal abnormalities
- fluid mediated teratogenesis
abnormal placental development
- increased risk of pre-eclampsia

Question 4

How does maternal hyperglycaemia affect the pregnancy in the late 2nd and 3rd trimester

Answer 4

• excessive fat deposition

- adverse fetal programming

Question 5

How should you prevent fetal malformation due to hyperglycaemia in pregnancy

Answer 5

check risk factors: 
previous GD
obesity
PCOS
FH of T2DM
high risk racial group

Question 6

What is macrosomia (large baby) due to and what are the symptoms

Answer 6

hyperglycaemia in the 3rd trimester
a difficult birth, shoulder dystocia, breathing problems
jaundice + hypocalcaemia/glycaemia + polycythemia