Medical Diseases in Pregnancy

Question 1

Fetal Complications of Diabetes in Pregnancy?

Answer 1

Macrosomia (25-40%)

Polyhydramnios (25%)

• Maternal hyperglycaemia causes fetal hyperglycaemia, which in turn causes both fetal osmotic diuresis (resulting in polyhydramnios) and fetal hyperinsulinemia

Congenital abnormalities (NTDs, microcephaly, cardiac or renal abnormalities, sacral agenesis)

IUGR

Question 2

Neonatal Complications of Diabetes in Pregnancy?

Answer 2

Polycythaemia (may cause jaundice)

• Fetal hyperinsulinemiacauses macrosomia (may cause obstructed labour) and increases erythropoiesis (which causes polycythaemia)

Hypoglycaemia

• Hyperinsulinemia also causes neonatal hypoglycaemia, because there is an excess of insulin when the maternal glucose supply is removed at birth

Hypocalcaemia

Hypothermia

Cardiomegaly

Birth trauma (shoulder dystocia, fractures, brachial plexus injury, asphyxia)

Respiratory distress syndrome

Question 3

Maternal Complications of Diabetes in Pregnancy?

Answer 3

Obstructed labour (shoulder dystocia, instrumental delivery, CAESAREAN)

Complications of DM (increased risk of retinopathy, nephropathy, UTI and cardiac disease)

Increased risk of PIH and pre-eclampsia

Question 4

Antenatal Care of Diabteic Mother?

Answer 4

Question 5

Postnatal Care of Diabteic Mother?

Answer 5

Question 6

Why is Vit K given to newborns?

Answer 6

Reduce risk of haemorrhagic disease of the neonate