Endocrinology of Pregnancy Flashcards Preview

SM Endocrine > Endocrinology of Pregnancy > Flashcards

Flashcards in Endocrinology of Pregnancy Deck (58):
1

What days does follicular growth occur

1 -9

2

At what day in the ovarian cycle does LH spike

13-15

3

What days does occupation occur

usually 15

4

What is the fate of the ovum

Ovum to corpus luteum to placenta

5

What hormones does the placenta produce

Human placental lactogen
placental progesterone
palcental oestrogens

6

What does the corpus luteum produce

Progesterone

7

What does the ovium produce

Oestradiol

8

What hormone does the pituitary gland produce that is particularly important to pregnancy

Prolactin (lactogen)

9

Why does gestational diabetes occur

Hormones cause an increase in insulin resistance

10

What 2 hormones can cause an increase in insulin resistance in the mother

Progesterones and hPL

11

When does gestational diabetes occur in pregnancy

The 3rd trimester (28 weeks)

12

When does foetal organogenesis occur

5 weeks (around the time the mother realises she has missed a period and notices she might be pregnant)

13

What are 6 complications in pregnancy for mothers with either type 1 or type 2 diabetes

congenital malformation
prematurity
intra-uterine growth retardation (IUGR)
Macrosomia
Polyhydramnios
Intrauterine death

14

What complications can occur in gestational diabetes

Macrosomia
Polyhydramnios
Intrauterine death

15

What is polyhydramnios

fluid around the baby resulting in premature death and early delivery

16

what are some of the complications in a neonate of a mother with diabetes

Respiratory distress - immature lungs
Hypoglycaemia
Hypocalcaemia

17

Why would a neonate end up hypoglycaemic rather than hyperglycaemic

The pancreas has had to secrete more insulin during development due to the mothers increased glucose level. Now there is a normal glucose level but still too much insulin..

18

What part of the spine is affected by caudal regression syndrome

Lumbar spine

19

What patients are affected by caudal regression syndrome

Babies to mothers with diabetes. Unusual outside diabetes

20

What is a major growth factor for a foetus

When it produces its own insulin in the 3rd trimester

21

How can we manage patients with diabetes

Pre-pregnancy counselling and ensuring good glycemic control
Folic acid 5mg
Regular eye checks
Avoid ACEI an statins

22

What does folic acid do

Reduces the risk of CNS congenital malformations

23

What is the dose for a non-diabetic pregnant woman and a diabetic pregnant woman

400micrograms for non-diabetic
5milligrams for diabetic

24

What drugs can be used to control blood pressure in pregnancy

Labetalol
Nifedipine
Methyl dopa

25

How can we maintain good blood glucose during labour

IV insulin and IV dextrose

26

How often should blood sugars be monitored during pregnancy

pre-meal
post-meal and pre bed
some will do one during the night as well

27

What drugs can be used to control glucose levels during pregnancy

Insulin
Metformin
Glibenclamide

28

What type of diabetes is indicative of glibenclamide

MODY

29

When should a woman who has had gestational diabetes be tested again to ensure the blood glucose has returned to normal

6 weeks post natal

30

If the glucose levels have not returned to normal after 6 weeks, what does this indicate

Either type 1 or Type 2 diabetes

31

How can we prevent diabetes after gestational diabetes

Keep weight as low as possible
Healthy diet
Aerobic exercise
Annual fasting glucose

32

Foetal hyperinsulinaemia causes increased foetal growth

True

33

What is the risk of type 2 diabetes in a mother who developed gestational diabetes within 10 years after the baby has been born

50%

34

What is maternal thyroxine particularly important for

Neonatal development

35

What is the usual increase in the dose of thyroxine in a pregnant lady already on thyroxine

25mcg

36

What are some normal findings of thyroid tests during pregnancy

Low TSH
increased fT4

37

How often should TFTs be checked during pregnancy

Monthly for first 20 weeks then 2 monthly until term

38

What is the optimum level of TSH in the first trimester

39

What is the optimum level of TSH in the second or third trimester

40

What are some of the risks of untreated hypothyroidism

Increased abortion, preeclampsia, abruption, postpartum, haemorrhage,
preterm labour
Increased risk of foetal neuropsychological development

41

What are some causes of thyrtoxicosis and pregnancy

Grave's disease
TMNG, toxic adenoma
Thyroiditis
Gestational hCG associated Thyrotoxicosis

42

What hormones can increase thyroxine

TSH and hCG

43

What happen if there is an increase in thyroxine

Suppression of TSH

44

What can hyperthyroidism cause in pregnancy

Infertility
Spontaneous miscarriage
stillbirth
thyroid crisis in labour
Grave's disease
Transient neonatal thyrotoxicosis

45

What are some signs that a baby may hyperthyroid

Not good at feeding, failing to put on weight, fidgety

46

What is transient neonatal thyrotoxicosis

When auto-antibodies from the mum have passed to the baby through the placenta and remain in the baby for 4-6 weeks until they are excreted from the baby's body

47

What is the main strategy applied for hyperthyroidism in pregnancy

conservative and supportive management

48

What can be used if hyperthyroidism is unmanageable

Beta blockers
Low dose anti-thyroid drugs

49

What antithyroid drug can be used in the 1st trimester

Propylthiouracil

50

What antithyroid drug can be used in the 2nd or 3rd trimester

Carbimazole

51

Why is carbimazole not used in the 1st trimester

Proven to cause foetal abnormalities

52

Why is propylthiouracil not used in the 2nd and 3rd trimester

Can cause liver damage

53

If TRAb antibodies cross the placenta, what can they cause

Neonatal transient hyperthyroidism

54

When should TRAb antibodies be tested

Ideally third trimester

55

What percentage of postpartum women have postpartum thyroiditis

5%

56

What do patients present with if they have postpartum thyroiditis

small diffuse, non-tender goitre

57

When is the classic time to develop hyperemesis

10th week of pregnancy

58

If a patient still needs thyroxine 1 year after delivery, how likely is it that she will require it life-long

Very likely