Diabetes Management in Pregnancy
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Questions and Answers

What is the target fasting blood glucose level for pregnant women with diabetes?

  • ≤ 95 mg/dL (correct)
  • ≤ 100 mg/dL
  • ≤ 110 mg/dL
  • ≤ 80 mg/dL
  • How many diabetic mothers are approximately delivered by Cesarean section?

  • 70%
  • 50% (correct)
  • 90%
  • 30%
  • During which time frame should blood glucose levels be monitored to avoid hypoglycemia during pregnancy?

  • Midnight to 2 AM
  • 2 AM to 6 AM (correct)
  • 8 AM to 10 AM
  • 1 PM to 4 PM
  • What is emphasized as important for optimal glycemic control and pregnancy outcome prior to conception?

    <p>Pre-pregnancy counseling</p> Signup and view all the answers

    What factor does NOT influence the mode of delivery for pregnant women with diabetes?

    <p>Fetal heart rate</p> Signup and view all the answers

    What complication is associated with excessive fetal growth in infants of diabetic mothers?

    <p>Macrosomia</p> Signup and view all the answers

    Which factor is NOT linked to the severity of congenital malformations in infants of diabetic mothers?

    <p>Maternal physical activity</p> Signup and view all the answers

    What does elevated Glycosylated Hemoglobin A (HbA1c) levels indicate when measured before 14 weeks of gestation?

    <p>Poor maternal glucose control over the past three months</p> Signup and view all the answers

    Which complication is linked to hypoxia and poor glycemic control in infants born to diabetic mothers?

    <p>Fetal Death</p> Signup and view all the answers

    What is often evaluated during an ultrasound examination at 20-22 weeks of gestation in diabetic mothers?

    <p>Cardiac defects and structural malformations</p> Signup and view all the answers

    Which factors allow for the continuation of pregnancy while awaiting labor onset?

    <p>Young primigravidae or multiparae with a good obstetric history</p> Signup and view all the answers

    What is a critical method used to assess fetal condition during labor?

    <p>Constant fetal monitoring (CTG)</p> Signup and view all the answers

    What potential problem may occur during labor that is specifically related to the fetal position?

    <p>Shoulder dystocia</p> Signup and view all the answers

    What microscopic change may be observed in the placenta of a diabetic pregnancy?

    <p>Villi edema and excessive syncytial knots</p> Signup and view all the answers

    Which sequence of events describes the pathology of diabetic ketoacidosis?

    <p>Insulin resistance → Lipolysis → Enhanced ketogenesis → Fall in plasma HCO3 and pH</p> Signup and view all the answers

    What fasting plasma glucose level is considered critical for a good fetal outcome in women with gestational diabetes mellitus?

    <p>90 mg/dL</p> Signup and view all the answers

    At what 2-hour glucose level after a 75 gm glucose test is a diagnosis of gestational diabetes made according to WHO criteria?

    <p>140 mg/dL</p> Signup and view all the answers

    What percentage of total calories should carbohydrates comprise for normal weight women managing gestational diabetes?

    <p>40-50%</p> Signup and view all the answers

    Which of the following complications is NOT associated with gestational diabetes mellitus?

    <p>Gestational hypertension</p> Signup and view all the answers

    What is the recommended caloric intake range for overweight women diagnosed with gestational diabetes?

    <p>1200-1800 kcal/day</p> Signup and view all the answers

    What is the diagnostic criterion for overt diabetes if fasting plasma glucose levels exceed which threshold?

    <p>126 mg/dL</p> Signup and view all the answers

    What proportion of women with gestational diabetes mellitus may eventually require insulin therapy?

    <p>25%</p> Signup and view all the answers

    Which of the following is a long-term risk for women who have experienced gestational diabetes?

    <p>Development of type 2 diabetes</p> Signup and view all the answers

    What is one of the primary causes of neonatal deaths in diabetic pregnancies?

    <p>Hypoglycemia</p> Signup and view all the answers

    What is the recommended calorie intake for an overweight pregnant woman with diabetes?

    <p>24 kcal/kg</p> Signup and view all the answers

    What percentage of risk for a diabetic child is associated if both parents are diabetic?

    <p>40%</p> Signup and view all the answers

    How often should antenatal appointments be conducted after week 20 of pregnancy for women with diabetes?

    <p>Every two weeks</p> Signup and view all the answers

    What is a critical management step to achieve better pregnancy outcomes in diabetic women?

    <p>Careful antenatal supervision and glycemic control</p> Signup and view all the answers

    What is a common characteristic of Type-1 diabetes mellitus?

    <p>Absolute insulinopenia</p> Signup and view all the answers

    Which of the following factors may contribute to fetal overgrowth in diabetes?

    <p>Elevated free fatty acids</p> Signup and view all the answers

    What is the significance of detecting glycosuria before the 20th week of pregnancy?

    <p>It usually requires a glucose tolerance test.</p> Signup and view all the answers

    Which of the following constitutes a potential candidate for Gestational Diabetes Mellitus (GDM)?

    <p>History of recurrent candidiasis</p> Signup and view all the answers

    Which test result indicates that a woman does not need a glucose tolerance test?

    <p>Fasting plasma glucose ≥ 126 mg/dL on repeat testing</p> Signup and view all the answers

    What is a key factor affecting insulin resistance during pregnancy?

    <p>Chronic low-grade inflammation</p> Signup and view all the answers

    When is routine screening for gestational diabetes typically recommended for high-risk individuals?

    <p>Between 24 and 28 weeks of pregnancy</p> Signup and view all the answers

    Which condition may signal the need for a glucose tolerance test during pregnancy?

    <p>Family history of diabetes</p> Signup and view all the answers

    What is the role of HDL cholesterol in the context of diabetes?

    <p>It acts as a plasma antioxidant.</p> Signup and view all the answers

    What is the primary factor that increases insulin requirement during pregnancy?

    <p>Altered carbohydrate metabolism</p> Signup and view all the answers

    Which of the following is NOT a complication associated with maternal diabetes during pregnancy?

    <p>Puerperal sepsis</p> Signup and view all the answers

    How does vasculopathy affect pregnant women with diabetes?

    <p>It predicts adverse pregnancy outcomes</p> Signup and view all the answers

    What is a potential fetal complication associated with maternal diabetes?

    <p>Fetal macrosomia</p> Signup and view all the answers

    Which of the following is a common association seen in diabetes that may lead to polyhydramnios?

    <p>Fetal hyperglycemia leading to polyuria</p> Signup and view all the answers

    What is a key predictive factor for the perinatal outcome in pregnant women with diabetic nephropathy?

    <p>Proteinuria &gt; 3 g/24 hours</p> Signup and view all the answers

    Which of the following factors can precipitate ketoacidosis in pregnant diabetics?

    <p>Hyperemesis and fasting</p> Signup and view all the answers

    What characterizes diabetic retinopathy in pregnant women with diabetes?

    <p>Proliferative retinopathy with neovascularization</p> Signup and view all the answers

    What condition is most likely to occur due to prolonged labor in diabetic pregnant women?

    <p>Shoulder dystocia</p> Signup and view all the answers

    What is the consequence of polyhydramnios during pregnancy?

    <p>Increased maternal stress</p> Signup and view all the answers

    Study Notes

    • Self-monitoring of capillary blood glucose is recommended for optimal glycemic control. Goals of capillary blood glucose levels (mg/dL) are: fasting ≤ 95; 2 hr. postprandial ≤ 120; 2 am to 6 am ≥ 60; Mean 100 and HbA1c ≤ 6 (ACOG-2005).
    • Timing of delivery should be with fetal maturation provided diabetes is well controlled and fetal surveillance is normal.
    • Mode of delivery depends on the level of glycemic control, fetal size, associated complications (if any [preeclampsia]), and pelvic adequacy. As such 50% of diabetic mothers are delivered by cesarean section. However, selected women may be considered for induction of labor and/or vaginal delivery.
    • Pre-pregnancy counseling is ideally done for all such women for optimum glycemic control a pregnancy outcome.

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    Description

    Test your knowledge on the management of diabetes during pregnancy with this quiz. Explore key concepts such as fasting blood glucose levels, Cesarean delivery rates, and monitoring practices. Understand the implications of glycemic control on pregnancy outcomes and complications associated with diabetes in mothers.

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