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21 Cards in this Set
- Front
- Back
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type 1 pregestational
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absolute insulin deficiency
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type 2 pregestational
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insulin resistance or deficiency
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gestational diabetes defined
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glucose intolerance due to pregnancy
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risks during wk 1-20
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increased risk for HYPOglycemia.. insulin production increases (n/v)
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risks during wk 20-40
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increased risk for HYPERglycemia.. BS increases as well as cortisol (decreases insulin effects)
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------ hormones cause insulin resistance
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placental
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risk factors for gestational diabetes
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prior Hx
obesity family Hx of DM2 multiple pregnancies age >25 Hx of polycystic ovaries AA, latina, native american, pacific islander previous fetal death previous infant >9lb |
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1st screening for gestational diabetes is
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50g glucose challenge
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a result of _____________ in an initial glucose challenge requires no further testing
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BS <140
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This test is required if initial glucose challenge is abnormal
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3hr GTT
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Dx of gestational diabetes is confirmed if these tests are positive
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1 hr glucose challenge
3 hr GTT |
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The medical Tx of choice for gestational diabetes is
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insulin injection. we dont know effects of oral insulin on fetus
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best mgmt Tx for gestational diabetes
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diet control:
45% complex carbs 20% protein 35% fat |
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normal weight gain during pregnancy is
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25-35 pounds
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schedule of visits for a gestational diabetic mom
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q 2 wk in 1st and 2nd trimester
q wk in 3rd AFP test at 16 wks sonography 18 wks fetal echo 20 wks 28-34 wks sonography again |
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teach mom to monitor BS....
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on rising
1-2 hr after breakfast before and after lunch before dinner bedtime |
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fetal complications r/t gestational diabetes
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LGA/macrosomia: >8lb 13oz
SGA: <10% for GA underdeveloped fetus labor dystocia shoulder dystocia canal damage fetal hyperglycemia fetal hypocalcemia >WBC >bilirubin childhood obesity preterm cord prolapse RDS asphyxia cardiac defects neural tube defects |
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maternal complications r/t gestational diabetes
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anxiety, guilt, fear
hypoglycemia |
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psychosocial interventions for mom
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develop positive coping mechanisms
focus on 'normal' part of pregnancy allow mom to make decisions about diet acknowledge concerns |
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most common post partal neonatal complications
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RDS
hyperbilirubinemia hyper/hypoglycemia - most likely hypo |
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post partal maternal care
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monitor BS
> calories if breastfeeding s/s of hypo/hyperglycemia |
