Infant of diabetic mother

Question 1

Definition

Answer 1

Neonate born to diabetic mother (Frank or gestational diabetes mellitus). Features y Commonly delivered preterm with ĺFMVXL[IMKLX0EVKIJSVKIWXEXMSREPEKI y Plump with puffy plethoric facies

Question 2

Metabolic problems

Answer 2

o Hypoglycemia (in 25 %)
o Hypocalcaemia & hypomagnesemia due to: transient hypoparathyroidism
o Hyperbilirunbinaemia due to: polycythaemia and reduced RBCs life span

(Both hypoglycemia and hypocalcaemia pjitteriness and seizures)

Question 3

Respiratory

Answer 3

o Respiratory distress syndrome o Transient tachypnea of newborn

Question 4

Hyper insulinemic features

Answer 4

o Macrosomia may predispose to difficult labor & birth injury o Transient hypertrophic cardiomyopathy o Visceromegaly o Polycythemia (Renal vein thrombosis is common)

Question 5

Congenital anomalies

Answer 5

(are 3 fold common, especially) o Congenital heart diseases o Sacral agenesis o Left microcolon o Neural tube defects

Question 6

Management

Answer 6

• Proper control of maternal diabetes and follow guidelines for preterm delivery * Natal and postnatal

y Delivery room and NICU care y Treatment of hypoglycemia

• Encourage early feeding
• Monitor blood glucose before every feed
• Manage hypoglycemia as before y Observe for and manage complications
• Polycythemia ( hydration , partial exchange)
• Jaundice (phototherapy)
• Echocardiography if heart murmurs or other signs suggesting congenital heart or cardiomyopathy y Discharge if no hypoglycemia for 24–48 hours on enteral feeds only and no other complication