38 Questions
What is the initial treatment for a symptomatic neonate with hypoglycemia?
IV bolus of 200mg/kg of 10% glucose
What is the maximum dose of glucagon for neonates?
1 mg/dose
What is the goal of initial IV infusion rate in hypoglycemic neonates?
4.2 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
What is the contraindication for treatment of hypoglycemia?
Hypertonic glucose
What is the recommended frequency of blood glucose level measurement?
Hourly, then every 4-6 hours when normal
What percentage of women are noted to have gestational diabetes during pregnancy?
5%
What is the primary reason for poor pregnancy outcomes in diabetic mothers?
Inadequate glycemic control before and during pregnancy
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
What is the recommended HbA1c level for pregestational diabetes to achieve the best outcomes for the mother and the baby?
HbA1c < 6.5%
What is the primary goal of treating gestational diabetes?
Decreasing the rate of serious perinatal outcomes
What is the primary cause of fetal mortality rate in diabetic mothers, especially after 32 weeks?
Poorly controlled maternal diabetes
What is the definition of hypoglycemia in infants?
Serum glucose < 2.6 mmol/L
What is the percentage of infants born to diabetic mothers who are large for gestational age?
36-45%
What is the recommended course of action for asymptomatic infants?
Undertake blood glucose determination within 1-2 hours of age
What is the primary mechanism by which poorly controlled maternal diabetes leads to fetal hyperglycemia?
Maternal hyperglycemia
What is the consequence of fetal hyperglycemia on the fetal pancreas?
Hyperplasia and hypertrophy of β cells
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
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
What is the risk of congenital malformations in gestational diabetes compared to the general population?
Slightly higher
What is the alternative treatment to insulin therapy for gestational diabetes?
Glyburide
What is the benefit of treating gestational diabetes with glyburide?
Reduced risk of macrosomia and neonatal hypoglycemia
What is the primary function of fetal hyperinsulinemia in the last trimester?
Increased fat and protein synthesis
What is the result of sudden separation of the placenta at birth?
Hypoglycemia and attenuated lipolysis
What is the primary mechanism by which maternal diabetes affects the fetus?
Maternal hyperglycemia leads to fetal hyperglycemia
What is a common clinical manifestation of infants of diabetic mothers (IDM)?
Macrosomia
What is the pathophysiological mechanism underlying fetal acidosis?
Maternal hyperglycemia and fetal hyperinsulinemia
What is the incidence of hypoglycemia in infants of diabetic mothers (IDM)?
25-50%
What is the possible reason for the higher incidence of respiratory distress syndrome (RDS) in IDM?
Insulin's antagonistic effect on surfactant synthesis
What is the primary approach to prevent macrosomic fetal growth and neonatal hypoglycemia?
Strictly controlling maternal diabetes during pregnancy
What is the percentage of cardiomegaly in infants of diabetic mothers?
30%
What is the incidence of congenital anomalies increased in infants of diabetic mothers?
4 folds
What is the characteristic of anencephaly?
A birth defect in which a baby is born without parts of the brain and skull
What is the long-term prognosis for infants of diabetic mothers in terms of physical development?
Normal physical development
What is the benefit of periconception glucose control in infants of diabetic mothers?
Reducing the risk of anomalies and other adverse outcomes
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
What is the benefit of glucose control during labor in infants of diabetic mothers?
Reducing the risk of neonatal hypoglycemia
What is the treatment approach for infants of diabetic mothers?
Initiating treatment before birth through frequent prenatal evaluation and planning of delivery
Explore the impact of diabetes on fetal and neonatal wellbeing during pregnancy, including gestational diabetes and pre-existing diabetes. Learn about the importance of glycemic control and prepregnancy planning.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
