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Endocrine > Endocrinology in Pregnancy > Flashcards

Endocrinology in Pregnancy Flashcards

1
Q

What hormone is produced by the follicle?

A

oestradiol

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2
Q

Name the hormone that causes ovulation

A

Luteinizing hormone (LH)

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3
Q

What hormone is produced by the fertilised ovum?

A

Progesterone

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4
Q

As a result of implantation what hormone is produced?

A

HCG

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5
Q

Name three hormones produced by the placenta

A
  • human placental lactogen
  • placental progesterone
  • placental oestrogen
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6
Q

What hormone does the pituitary gland produce in response to pregnancy?

A

Prolactin

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7
Q

How can gestational diabetes arise?

A

Progesterones & hPL make the mother insulin resistant in order to distribute food to the foetus. However if the mother is predisposed to diabetes & has a high blood glucose this will result in gestational diabetes

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8
Q

When does foetal organogenesis start?

A

Around 5 weeks

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9
Q

What are the risks for type 1 & 2 diabetics in pregnancy?

A
  • congenital malformation
  • prematurity
  • intra-uterine growth retardation
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10
Q

What are the risks of type 1, 2 and gestational diabetes in pregnancy?

A

Macrosomia (may cause problems with delivery)
Polyhydramios
Intrauterine death

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11
Q

State three neonatal complications

A
  • respiratory distress
  • hypoglycaemia
  • hypocalcaemia
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12
Q

How can hypoglycaemia and hypocalcaemia present?

A

Fits - can lead to permanent brain damage

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13
Q

How is pregnancy in diabetics managed?

A
  • pre-pregnancy counselling
  • folic acid 5mg
  • aspirin at 10-12 weeks (reduces risk of preeclampsia)
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14
Q

What drugs should be avoided?

A

ACE inhibitors & statins

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15
Q

What drug is used to treat hypertension in pregnant women?

A

Beta blockers - labetalol

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16
Q

How can diabetes be managed during labour?

A

IV insulin/dextrose

17
Q

What is the first line treatment for gestational diabetes?

A

Lifestyle but may need metformin/insulin

18
Q

How long after birth is the mother’s blood sugars checked?

A

6 week post natal fasting glucose

19
Q

What is the risk of developing type 2 diabetes post natal?

A

50% (80% if obese)

20
Q

How often are women with a history of gestational diabetes screened?

A

Annually

21
Q

What can hypo/hyperthyroidism cause?

A

Anovulatory cycles - reduced fertility

22
Q

What happens to thyroxine during pregnancy?

A

It increases as it is very important for neonatal development

23
Q

By how much should levothyroxine be increased?

A

25mcg ASAP usually increased by 50% by 20 weeks

24
Q

What is the target TSH in pregnant women?

A

<3

25
Q

If hypothyroidism is left untreated during pregnancy what can happen?

A

abortion, preeclampsia, preterm labour, neuropsychological defects (lower IQ)

26
Q

What is the effect of HCG on the thyroid?

A

HCG increases thyroxine & suppresses TSH leading to hyperemesis which is associated with sickness also caused by HCG

27
Q

How can you tell the difference between hyperemesis & hyperthyroidism?

A

TRAB antibody testing, wait and see - hyperemesis will resolve over time (treat if it persists > 20 weeks)

28
Q

What risks are associated with hyperthyroidism?

A

miscarriage, still birth, thyroid crisis, neonatal hyperthyroidism

29
Q

How is hyperthyroidism treated in pregnancy?

A 
Supportive treatment (symptomatically - fluids/beta blockers/anti-emetic)
Low dose anti-thyroid drugs
30
Q

What anti-thyroid drugs can be used in hyperthyroidism?

A

1st trimester - propylthiouracil

2nd/3rd trimester - carbimazol

31
Q

What is the main risk associated with propylthiouracil?

A

Liver toxicity

32
Q

What is the main risk associated with carbimazol?

A

embryopathy - 1st trimester

33
Q

State a vital test in mothers with hyperthyroidsim

A

TRab - can be passed through the placenta to the baby and cause hyperthyroidism

34
Q

Describe what can happen postpartum

A

Mother can experience hyperthyroidism (6-8 weeks post natal) then hypothyroidism (3-4months post natal) and then it either remains hypothyroidism or comes back to norma l

35
Q

What is postpartum hypothyroidism often associated with?

A

Post natal depression (or exacerbation of autoimmune disease)

Endocrine (17 decks)

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