Respiratory, Endocrine, &Genetic Disorders Flashcards
There is a peak in relative insulin insensitivity during which part pf pregnancy?
26-28 weeks gestation
Gestationl Diabetes timeframe?
Begins 24-26 wks, up to 6 wk PP
What causes the insulin resistance during pregnancy
human placenta hormone (hPL)
When does gestational dibetes screning take place?
24-28 wks
Gestational Diabetes Screening: 3 Hour OGTT
- Uses 100 g Fasting for 3 Hour OGTT
- If 2 or more abnormal values = GDM
Diabetes Screening: 3 Hour OGTT Normal serum values?
Fasting <105 mg/dl
1 hour <190 mg/dl
2 hours <165 mg/dl
3 hours <145 mg/dl
Diabetes Screening: 2 hour OGTT
- One or more of the values must be equaled or exceeded for the diagnosis of GDM.
- Fasting 92 mg/dl
- 1 hour 180 mg/dl
- 2 hours 153 mg/dl
Potential Pregnancy Dangers with Diabetes (Fetus)
- increase Neural tube defects
- Macrosomia
- IUGR
Potential Pregnancy Dangers with Diabetes (Neonate)
- Hypoglycemia
- Hypocalcemia
- Polycythemia
- Hyperbilirubinemia
What happens to insulin needs after delivery?
insulin needs drop significantly in 1st 24hrs
What happens to the thyroid during pregnancy?
usually enlarges
What effect does Hcg and estrogen have on T3/T4 levels?
they increase
Labs that differentiate hyperthyroidism in pregnancy?
-increased T4/T3, significantly decreased TSH
Do thyroid meds cross the placenta?
yes (ex. synthroid)
Labs that differentiate hypothyroidism in pregnancy and tx?
- increased TSH with or without decreased T4(free Thyroxine)
- Treatment: Levothyroxine (eg. Synthroid)
How is Sickle Cell transmitted?
autosomal recessive inheritance (25% chance)
Complications of Sickle Cell Anemia in Pregnancy include an increased risk of?
- High fetal wastage (Spontaneous AB, stillbirth)
- Hemolytic anemia
- UTIs & pyelonephritis
- Urinalysis each trimester even with SC Trait
- Hematuria
- Leg ulcers
- Increased maternal mortality & morbidity (5-10 %)
- Increased susceptibility to infection
- Pre-eclampsia
How is Cystic Fibrosis transmitted?
Autosomal Recessive Inheritance 25% risk of inheritance
Most common fatal autosomal recessive genetic disorder in Caucasian children?
Cystic Fibrosis
The below are potential dangers for neonates in which disorder:
- Hypoglycemia
- Hypocalcemia
- Polycythemia
- Hyperbilirubinemia
Diabetes
The below are potential dangers for a fetus in which disorder:
- increase Neural tube defects
- Macrosomia
- IUGR
Diabetes
