8: Diabetes and endocrinology in pregnancy Flashcards Preview

Endocrine Week 3 2017/18 > 8: Diabetes and endocrinology in pregnancy > Flashcards

Flashcards in 8: Diabetes and endocrinology in pregnancy Deck (6)
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1

The jist of diabetes

Pregnant women can get gestational diabetes, 3rd trimester - 50% chance of > T2 after birth, give drugs  (metformin / insulin) only if poor glycaemic control

Untreated T1 diabetes in a prego mother is terrible for kiddo - birth defects, macrosomia

Pregnancy must be planned so glycaemic control is in place BEFORE conception

Intensely support mother after birth to reduce risk of progression to T2

2

Jist of thyroid disease:

Hypothyroidism causes heavy periods, hyperthyroidism causes light periods

Thyroxine demand of mother increases during pregnancy > hypothyroidism > so increase their medication if they're already on thyroxine

Untreated hypothyroidism and thyrotoxicosis will result in birth defects

Give anti-thyroid drugs as late and in as low a dose as possible

3

Jist of thyroiditis:

Post-birth women may develop post-partum thyroiditis, producing hyperthyroid at 6 weeks, then hypothyroid (so make sure they're off carbimazole at this point and get them on thyroxine if symptomatic, then slowly withdraw)

Small goitre

4

hPL and progesterone produce insulin resistance in pregnant mothers - physiological because glucose isn't stored and instead goes to baby

but if you're already insulin resistant you'll get gestational diabetes

5

folic acid in all pregnant mothers!!!

6

hyperglycaemia in mother during pregancy means baby is producing loads of insulin

upon birth they still will be --> hypoglycaemia, fitting