Pregnancy and water balance Flashcards
What are the three key events in the ovarian cycle?
- Follicular growth
- Ovulation
- Luteal function
What are the gonadotrophic hormones involved in the ovarian cycle?
Follicle stimulating hormone (FSH)
Luteinizing hormone (LH)
What are the ovarian hormoes involed in the ovarian cycle?
Estrogen
Inhibin
Progesterone
Name all the hormones involved in the ovarian cycle
Folicular stimulating hormone FSH
Luteinizing hormone LH
Estrogen
Inhibin
Progesterone
When are FSH and LH at their highest?
Ovulation
When does ovulation usually occour in the ovarian cycle?
day 14
When is progesterone at its highest and when is it at its lowest?
Low in menses and proliferative phase
High in secretory phase
What happens to the foetus in maternal hyperglycaemia
Macrosomia
(birth weight >4kg)
What suppliment should diabetic patients who are pregnant take ?
Folic acid
What common drugs must be avoided in diabetic pregnancy?
ACE inhibiors
Statins
What are the blood sugar targets before and after a meal in diabetic pregnancies?
pre-meal <4-5.5 mmol/L
2h post meal <7 mmol/L
How can Type 2 diabetes be prevented after gestational diabetes?
Low density foods
keep weight low
exercise
What usually happens to the thyroid during pregnancy?
Increaces in size
Increased T4 production
What stimulates increased thyroxine production in pregnancy?
hCG
What must you do in a patient with hypothyroidism who gets pregnant?
increase thyroxine dose by 25mg as soon as pregnancy is suspected
What will happen to the child of a mother with untreated hypothyroidism ?
Increased abortion
preeclampsia
postpartum haemorrhage
preterm labour
less intelligent child
What is a pregant woman with hyperthyroidism at risk of?
Infertility
spontaneous miscarriage
still birth
thyroid crisis in labour
Transient neonatal thyrotoxicosis
How do you approach hyperthyroid management in pregnancy?
Weight and see
What drugs can be used in hyperthyroidisim in pregnancy?
1st trimester - Propylthiouracil
2/3rd trimester- Carbimazole
What percentage of woman experiance postpartum thyroiditis?
5%
What regulates sodium in the body?
Mineralocorticoid activity
What does mineralcorticoid activity mean?
sodium retention in exchange for potassium and/or hydrogen ions
What is the main steroid with mineralocorticoid activity?
Aldoserone
what hormone controls water?
Anti-diuretic hormone
