Diabetes and Pregnancy

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What is the initial treatment for a symptomatic neonate with hypoglycemia?

Give crystalline glucagon IM or SC

IV bolus of 200mg/kg of 10% glucose (correct)

Administer hydrocortisone 5mg/kg/day IV or IM

Start IV Dextrose 10% at 60ml/kg/day

What is the maximum dose of glucagon for neonates?

0.3 mg/kg/dose

1.5 mg/kg/dose

2 mg/kg/dose

1 mg/dose (correct)

What is the goal of initial IV infusion rate in hypoglycemic neonates?

4.2 mg/kg/min glucose (correct)

8 mg/kg/min glucose

6 mg/kg/min glucose

10 mg/kg/min glucose

What is the next step if the initial IV infusion rate is inadequate?

Increase the infusion rate to 10-12 mg/kg/min Signup and view all the answers

What is the contraindication for treatment of hypoglycemia?

Hypertonic glucose Signup and view all the answers

What is the recommended frequency of blood glucose level measurement?

Hourly, then every 4-6 hours when normal Signup and view all the answers

What percentage of women are noted to have gestational diabetes during pregnancy?

5% Signup and view all the answers

What is the primary reason for poor pregnancy outcomes in diabetic mothers?

Inadequate glycemic control before and during pregnancy Signup and view all the answers

What is the average daily glucose level required for women with type 1 diabetes during pregnancy to deliver infants with normal birthweights and anthropomorphic features?

< 95 mg/dL Signup and view all the answers

What is the recommended HbA1c level for pregestational diabetes to achieve the best outcomes for the mother and the baby?

HbA1c < 6.5% Signup and view all the answers

What is the primary goal of treating gestational diabetes?

Decreasing the rate of serious perinatal outcomes Signup and view all the answers

What is the primary cause of fetal mortality rate in diabetic mothers, especially after 32 weeks?

Poorly controlled maternal diabetes Signup and view all the answers

What is the definition of hypoglycemia in infants?

Serum glucose < 2.6 mmol/L Signup and view all the answers

What is the percentage of infants born to diabetic mothers who are large for gestational age?

36-45% Signup and view all the answers

What is the recommended course of action for asymptomatic infants?

Undertake blood glucose determination within 1-2 hours of age Signup and view all the answers

What is the primary mechanism by which poorly controlled maternal diabetes leads to fetal hyperglycemia?

Maternal hyperglycemia Signup and view all the answers

What is the consequence of fetal hyperglycemia on the fetal pancreas?

Hyperplasia and hypertrophy of β cells Signup and view all the answers

What is the recommended treatment for infants with a glucose level between 1.2-2.5 mmol/L on the first testing?

Rub 0.5 ml/kg of 40% dextrose gel into buccal mucosa and feed the baby Signup and view all the answers

What is the recommended course of action for infants with glucose levels below 1.2 mmol/L at any stage?

Admit the infant to the NICU for close observation and treatment Signup and view all the answers

What is the risk of congenital malformations in gestational diabetes compared to the general population?

Slightly higher Signup and view all the answers

What is the alternative treatment to insulin therapy for gestational diabetes?

Glyburide Signup and view all the answers

What is the benefit of treating gestational diabetes with glyburide?

Reduced risk of macrosomia and neonatal hypoglycemia Signup and view all the answers

What is the primary function of fetal hyperinsulinemia in the last trimester?

Increased fat and protein synthesis Signup and view all the answers

What is the result of sudden separation of the placenta at birth?

Hypoglycemia and attenuated lipolysis Signup and view all the answers

What is the primary mechanism by which maternal diabetes affects the fetus?

Maternal hyperglycemia leads to fetal hyperglycemia Signup and view all the answers

What is a common clinical manifestation of infants of diabetic mothers (IDM)?

Macrosomia Signup and view all the answers

What is the pathophysiological mechanism underlying fetal acidosis?

Maternal hyperglycemia and fetal hyperinsulinemia Signup and view all the answers

What is the incidence of hypoglycemia in infants of diabetic mothers (IDM)?

25-50% Signup and view all the answers

What is the possible reason for the higher incidence of respiratory distress syndrome (RDS) in IDM?

Insulin's antagonistic effect on surfactant synthesis Signup and view all the answers

What is the primary approach to prevent macrosomic fetal growth and neonatal hypoglycemia?

Strictly controlling maternal diabetes during pregnancy Signup and view all the answers

What is the percentage of cardiomegaly in infants of diabetic mothers?

30% Signup and view all the answers

What is the incidence of congenital anomalies increased in infants of diabetic mothers?

4 folds Signup and view all the answers

What is the characteristic of anencephaly?

A birth defect in which a baby is born without parts of the brain and skull Signup and view all the answers

What is the long-term prognosis for infants of diabetic mothers in terms of physical development?

Normal physical development Signup and view all the answers

What is the benefit of periconception glucose control in infants of diabetic mothers?

Reducing the risk of anomalies and other adverse outcomes Signup and view all the answers

What is the characteristic of lumbosacral agenesis?

A condition characterized by absence of different segments of lumbar spine along with total or partial absence of the sacrum Signup and view all the answers

What is the benefit of glucose control during labor in infants of diabetic mothers?

Reducing the risk of neonatal hypoglycemia Signup and view all the answers

What is the treatment approach for infants of diabetic mothers?

Initiating treatment before birth through frequent prenatal evaluation and planning of delivery Signup and view all the answers