Gynaecology & Obstetrics
Medical, surgical and gynaecological illness complicating pregnancy
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All are true about diabetes in pregnancy except
High-Yield Explanation
Neonatal Effects of Diabetic complicated Pregnancy Respiratory Distress Syndrome Delayed lung maturation 2. Hypoglycemia Newborns of a diabetic mother experience a rapid drop in plasma glucose concentration after delivery Mainly attributed tohyperinsuliniemia produced by hyperplasia of the fetal b-islet cells induced by chronic maternal hyperglycemia Low glucose concentrations--defined as < 45 mg/dL--are paicularly common in newborns of women with unstable glucose concentrations during labor Prompt recognition and treatment of the hypoglycemic newborn minimizes adverse sequelae. 3. Hypocalcemia Defined as a total serum calcium concentration < 8 mg/dL in term newborns Cause has not been explained Theories include aberrations in magnesium-calcium economy, asphyxia, and preterm bih 4. Hyperbilirubinemia and Polycythemia Major contributing factor is newborn polycythemia, which increases the bilirubin load Polycythemia is thought to be a fetal response to relative chronic hypoxia Sources of this fetal hypoxia are hyperglycemia-mediated increase in maternal affinity for oxygen and fetal oxygen consumption Together with insulin-like growth factors, hypoxia leads to increased fetal erythropoietin levels and red cell production. 5. Cardiomyopathy Mainly hyperophic cardiomyopathy that primarily affects the interventricular septum In severe cases, this cardiomyopathy may lead to obstructive cardiac failure Most affected newborns are asymptomatic following bih, and hyperophy resolves in the months after delivery Relief from maternal hyperglycemia is presumed to promote this resolution Conversely, fetal cardiomyopathy may progress to adult cardiac disease. 6. Long-Term Cognitive Development Intrauterine metabolic conditions have been linked to neurodevelopment in offspring Autism spectrum disorders or developmental delay were more common in children of diabetic women 7. Inheritance of Diabetes The risk of developing type 1 diabetes if either parent is affected is 3 to 4 percent Type 2 diabetes has a much stronger genetic component. If both parents have type 2 diabetes, the risk of developing it approaches 40 percent Reference: William&;s Obstetrics; 24th edition; Chapter 57