Maternal Diesaes And Pregnancy: Endorcine And Metabolic Disorders

Question 1

What are some endocrine disorders in pregnancy? 3

Answer 1

1. Diabetes in pregnancy
2. Thyroid disease in pregnancy
3. Phenylketonuria (PKU)

Question 2

Diabetes in pregnancy can be categorized how? 3

Answer 2

1. Type 1
2. Type 2
3. Other (secondary)

Question 3

What is diabetes?

Answer 3

Problem with carbohydrate metabolism leading to hyperglycaemia or high blood sugar

Question 4

In terms of diabetes what are the ranges for spontaneous abortion?

Answer 4

15-20%

Question 5

How many infants are born with congenital abnormalities in terms of diabetes?

Answer 5

5-10%

Question 6

What is type1 diabetes? 2

Answer 6

1. Autoimmune disease
2. Immune system attacks and destroys insulin production in pancreas

Question 7

What is diabetes type 1 also called? What is it formally called?

Answer 7

1. Insulin dependent diabetes
2. Juvenile onset diabetes

Question 8

How is insulin controlled during type 1 diabetes?

Answer 8

Synthetic insulin

Question 9

How does diabetes type 1 affect pregnancy? What will we see? 2

Answer 9

1. Hyperglycaemia can disrupt organogenesis
2. CARDIAC defects are most commonly seen

Question 10

During early pregnancy diabeteic control is __________. This _________ the risk of congenital abnormalities.

Answer 10

1. Critical
2. Decreases

Question 11

Besides cardiac defects what do we see during diabetes type 1? 7

Answer 11

1. Brain
2. Blood vessels
3. Urinary system
4. GI tract
5. Spine
6. IUGR
7. Macrosomia

Question 12

What are some anomalies of the heart a diabetes type 1 patient may have? 5

Answer 12

1. Transposition of great vessels
2. Ventricular septal defect
3. Atrial septal defect
4. Coarctation of the aorta
5. Cardiomegaly

Question 13

What are some anomalies related to the CNS/ spine affected Diabetes type 1? 4

Answer 13

1. Caudal regression syndrome
2. Neural tube defect
3. Anencephaly
4. Microcephaly

Question 14

What are some anomalies the urinary system is affected by diabetes? 3

Answer 14

1. Hydronephrosis
2. Renal agenesis
3. Ureteral duplication

Question 15

What are some anomalies that GI system is affected by Diabetes type 1? 3

Answer 15

1. Duodenal atresia
2. Anorectal atresia
3. Small left colon syndrome

Question 16

What are some symptoms that happen if type 1 diabetes affect the fetus later in pregnancy? 5

Answer 16

1. Macrosomia
2. Anoxia due to pre-eclampsia
3. IUGR
4. Primary fetal hazard
5. Still birth or early neonatal death

Question 17

What is type 2 diabetes? How is it controlled?

Answer 17

1. Change in the ability to regulate and use glucose
2. Controlled by diet and/ or synthetic insulin

Question 18

How is type 2 developed?

Answer 18

Developed over time

Question 19

What is Gestational diabetes?

Answer 19

Developed because of pregnancy

Question 20

What are some possible complications of Type 2 Diabetes? 5

Answer 20

1. Maternal excessive weight gain
2. Polyhydraminos
3. Macrocosmic infant
4. Pre-eclampsia
5. Fetal death

Question 21

What is the ultrasound role in GDM? 2

Answer 21

1. Fetal assessments (BPP, Biometry, AFI)
2. Extra views for LGA fetus

Question 22

What should the fetal subcutaneous fat measurement for LGA GDM?

Answer 22

Should be <3mm

Question 23

What is the interventricular septum thickness for LGA GDM?

Answer 23

Should be <5mm

Question 24

What should the umbilical artery cord flow be for LGA GDM?

Answer 24

Flow should be low resistance

Question 25

Hyperthyroidism affects how many causes of pregnancies?

Answer 25

0.1% - 0.4% of pregnancies

Question 26

What are some possible complications of hyperthyroidism disease for pregnancies? 6

Answer 26

1. Thyroid storm (extreme hyperthyroidism) 2. Pre-term birth 3. Low birth weight 4. Spontaneous abortion 5. Congenital anomalies 6. Fetal goiter

Question 27

What is hyperthyroidism conditions treated with during pregnancies?

Answer 27

Propylthiouracil (PTU)

Question 28

Is hypothyroidism common with pregnancies? Why? 3

Answer 28

1. Rare since patient with this disorder having difficulty conceiving 2. Maternal gonadal failure 3. Multiple spontaneous abortion

Question 29

What is PKU stand for?

Answer 29

Phenylketonuria

Question 30

How does some get PKU?

Answer 30

Inherited autosomal recessive disease

Question 31

What is PKU? 2

Answer 31

1. Individuals lack the gene that creates enzymes that break down phenylalanine 2. Amino acid broken down from ingestion of protein

Question 32

How many infants are affected by PKU?

Answer 32

1 in 10,000 to 15,000 newborns

Question 33

Is it easy to know that you are afflicted by PKU?

Answer 33

Most women who have it know it

Question 34

Is PKU a common condition?

Answer 34

Common condition and is screened for in newborns

Question 35

If someone does not follow a low phenylalanine/ low protein diet what happens?

Answer 35

Develops potentially toxic levels of metabolic products

Question 36

Maternal dietary adjustments _____ inception are unsuccessful in preventing abnormalities in PKU.

Answer 36

After inception

Question 37

High levels of PKU can result in what? 6

Answer 37

1. Spontaneous abortion 2. Microcephaly 3. Intellectual disability 4. Congenital heart disease (CHD) 5. Low birth weight 5. Behavioural problems