Diabetes, abortions, ectopics Flashcards Preview

Repro II > Diabetes, abortions, ectopics > Flashcards

Flashcards in Diabetes, abortions, ectopics Deck (30):
1

LGA

>4000

2

class B

onset of DM at 20+ with duration <10yrs

3

class C

onset 10-19 with duration of 10-19 yrs

4

class D

onset 20

5

class E

overt DM with calcified pelvic vessels

6

DM I

uteroplacental insufficiency -> growth restriction

7

GDM

any degress of glucose intolerance with onset during pregnancy
dt HPL creating insulin resistance

8

risk factors of GDM

increased age and weight
previous GDM
previous macrosomic infant
FHx of DM
ethnic

9

blood glucose 1st trimester

decreased d/t increased insulin sensitivity and production

10

blood glucose 2nd-3rd trimester

insulin sensitivity decreases

11

early pregnancy

decreased hepatic glucose storage
decreased maternal fasting storage
increased B cell hyperplasia and insulin secretion
increased glycogen storage
increased glucose utilization
increased E and P

12

effects of DM on baby

macrosomnia
hypoglycemia
hyperbilirubinemia
low Ca and Mg
RDS
polycythemia
hyperviscosity
increased risk for obesity
increased risk for DMII

13

Acute complications of GDM

preterm labor
HTN
preeclampsia
increased risk for DMII

14

Dx GDM

fasting glucose <126
random glucose 200

15

interpartum care

IV fluids with dextrose
insulin for all DM I and some GDM/DMII

16

care during breastfeeding

insulin requirements usually lower

17

hCG in normal pregnancy

should double every 48 hours

18

risk factors for spontaneous abortion

age
previous spontaneous abortion
increasing gravidity
prolonged time to implantation or conception
smoking
EtOH
cocaine
NSAIDs around time of conception
caffeine
low folate
extremes of moms weight
fever
celiacs

19

fetal etiologies of spontaneous abortion

chromosomal abnormalities (50%)
trisomy 16 most common
congenital abnormalities
truama

20

maternal etiologies of spontaneous abortion

uterine structural issues
acute maternal infections
material endocrinopathies
hypercoaguable states

21

work up for spontaneous abortion

doppler
pelvic exam
pelvic US
hCG
blood type Ab screen
serum porgesterone

22

Dx with pelvic US

gestational sac >25mm that does not contain yolk sac/embryo
an embryoi with crown rump length >7mm that does not have cardiac activity

23

Dx with lack of development

absence of heart beat 11-14 days

24

threatened abortion

Dx criteria for spontaneous abortion not met
bleeding, but os closed
up to 50% will miscarry
bed rest

25

inevitable abortion

bleeding, cramping, dilated cervix

26

Tx of inevitable abortion

medical abortion (misopristol)
surgical abortion D&C
wait

27

incomplete abortion

bleeding, pain, cervix dilated, products of conception are found w/in cervical canal
after 12 wks membranes rupture and fetus is passed, but placental tissue may be retained

28

Tx of incomplete abortion

medical abortion (misopristol)
surgical abortion D&C
watch for Staph aureus infection

29

risk factors for ectopic

previous ectopic
PID
assisted repro technology
Hx of peritonitis
smoking
previous tubal ligation

30

Tx for ectopic

medical abortion (methotrexate)
surgical