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23 Cards in this Set
- Front
- Back
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1. What is fetal hyperinsulinemia a response to?
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a. Poorly controlled maternal hyperglycemia resulting in fetal macrosomia and increased fetal oxygen requirements.
b. High infant insulin levels cause him to become hypoglycemic when he is removed from the high-sugar in utero environment. |
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2. Other sequelae of gestational diabetes?
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a. Polycythemia
b. Hypocalcemia c. Hyperbilirubinemia |
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3. Gestational Diabetes?
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a. Persistent hyperglycemia during pregnancy, with untreated serum glucose levels greater than 100 mg/dl in the fasting state or greater than 130 mg/dl otherwise.
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4. Hypoglycemia?
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a. Blood glucose <40 is the usual definition although other definitions exist.
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5. Symptoms of hypoglycemia?
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a. Lethargy
b. Listlessness c. Poor feeding d. Temperature instability e. Apnea f. Cyanosis g. Jitteriness h. Tremors i. Seizure activity j. Respiratory distress |
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6. Macrosomia?
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a. >90th percentile for gestational age.
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7. Polycythemia + consequence?
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a. Elevated haematocrit that can lead to thrombosis if the level is significant and remains untreated.
b. Levels greater than 65% in a newborn are often treated by partial exchange transfusion. a. Elevated haematocrit that can lead to thrombosis if the level is significant and remains untreated. b. Levels greater than 65% in a newborn are often treated by partial exchange transfusion. |
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8. Caudal regression syndrome?
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a. Rare congenital malformation found almost exclusively in the IDM, characterized by hypoplasia of the sacrum and lower extremities.
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9. When are women screen for gestational diabetes?!?!
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a. 24-28 weeks.
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10. Note: DM It is classified according to maternal age when the condition is first diagnosed (onset during gestation or progestational), the duration of symptoms, and the presence of vasculopathy (the “White” classification).
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10. Note: DM It is classified according to maternal age when the condition is first diagnosed (onset during gestation or progestational), the duration of symptoms, and the presence of vasculopathy (the “White” classification).
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11. What are many of the congenital malformations associated w/gestational diabetes thought to result from?
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a. Hyperglycemia early in the pregnancy.
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12. Head circumference with diabetes?
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a. Significantly less than the large body bc insulin does not affect brain growth.
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13. How does polycythemia in the fetus result from maternal DM?
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a. Macrosomia, increased oxygen requirements, and placental insufficiency can lead to perinatal asphyxia and increase production of erythropoietin.
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14. How do elevated bilirubin levels result from maternal DM?
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a. They result from the polycythemia.
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15. Risk of elevated polycythemia in fetus?
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a. Can cause renal vein thrombosis.
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16. Risk with calcium in gestational DM?
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a. Hypocalcemia: Common and results in irritability and decreased myocardial contractility.
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17. What are the babies of insulin-dependent (type 1) diabetics at risk for?
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a. Congenital malformations, including:
1. Congenital heart disease 2. Neural tube defects 3. Caudal regression syndrome. b. May be Macrosomic with associated risks(shoulder dystocia, complicated delivery) c. May also be small for gestational age (IDM only) if the mother’s diabetes is associated w/severe vascular disease and resultant placental insufficiency. |
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18. Growth of IDM babies?
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a. Often small in childhood but are often overweight in adolescence.
b. They may be at risk for problems of obesity later in life. |
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19. Pulm risk to babies of type 1 DM mothers with poorly controlled diabetes?
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a. Respiratory distress syndrome at later ages than seen in infants born to mothers who do not have DM>
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20. Bilirubin type in baby with liver immaturity?
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a. Unconjugated (obvi)
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21. Heart risks in babies with poorly controlled gestational diabetes?
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a. Congenital heart anomalies
b. Cardiomyopathy c. Septal hypertrophy d. Subaortic stenosis. |
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22. Presentation of Renal vein thrombosis?
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a. Abdominal mass (hydronephrosis). Can occur as a complication of polycythemia in IDMs.
b. Infants may have gross haematuria, but microscopic haematuria is more common. c. HTN is uncommon following an acute thrombosis but may occur as a late complication. d. The affected kidney may recover normal function or it may atrophy. |
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23. Risk of bilateral renal vein thrombosis?
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a. Can lead to chronic renal failure.
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