which of the following statements about a woman who has gestational diabetes is false? This is a topic that many people are looking for. passionistsisters.org is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, passionistsisters.org would like to introduce to you Gestational Diabetes. Following along are instructions in the video below:
Gestational diabetes. Is the topic for this video. And i wanted to touch on just just a few brief points.
Because its a diabetes in general is a very topic. So what i wanted to touch on in this video is the fact that if a woman who was pregnant develops diabetes during her pregnancy. Thats known as gestational diabetes.
And that has important consequences. Because it can lead to some very severe problems in the fetus and theres a long list of them. But theres one in particular that i wanted to concentrate on and thats fetal macrosomia.
And what does that mean well fetal macrosomia is referring to a heavy baby so youre looking at about a birth weight. Between 4000. 4000 to 4500 grams and if this does happen because directly because of the gestational diabetes.
During delivery in particular vaginal delivery. It can lead to something known as shoulder dystocia and thats just simply. Because the the fetus is so large that the the delivery can result in this complication.
The the fetuses shoulder becomes impacted against the mothers pelvic bones of pubis symphysis and that can lead to this problem. When a woman does have her pregnancy testing over the course of her 38 weeks or 40 weeks.
One of those tests is called an oral glucose tolerance test. And this is a test that is done to screen for diabetes in pregnancy. And its done in two steps.
The first step what you do is you give the patient 50 grams of oral glucose and you wait one hour and then you test the blood sugar and if the blood glucose level is greater than 130. Then you proceed to the next step. Which is a 100 gram glucose load.
And then you wait three hours and then you test the blood glucose level. So thats known as the oral glucose tolerance test. Thats the way t you would diagnose gestational diabetes.
The treatment of gestational diabetes. Involves insulin insulin is by far the the best drug because it doesnt cross the placenta it does not cross the placenta. Other medications that can be used that are oral medications.
Included glyburide. Which is of course. A that pill.
So i wanted to get into some clinical vignettes. Now a 22 year old woman comes to the office.
Because she is very upset about a complication that occurred during the delivery of her through. However son three weeks ago. You have been treating her for various aches and pains since she was a child and she respects her opinions.
She had an appendectomy at age 12 and shoulder surgery. At age 18. Her prenatal course was complicated by gestational diabetes.
And you know that she smoked cigarettes and used cocaine during the pregnancy. Because her mother told. You she tells you that at 38 weeks gestation she was at a bar with her boyfriend and her water broke.
They were to the hospital and after pushing for three hours she delivered the fetal head. But the rest of the body. Just did not come want to come out the obstetrician had to deliver the baby by the posterior arm fracturing.
The humerus in the process. The factor in her history that most likely contributed to the difficult delivery is a good question. I think and kind of makes me think a little bit well.
The fact that she had surgery on her shoulder might sound similar to that what happened to the baby. But its unrelated maternal age really has some relation to shoulder dystocia dystocia.
But only if its advanced maternal age. Shes actually only 22. So advanced maternal age may if youre greater than 35.
So in her case. Its not that cigarette smoking has not been associated with shoulder dystocia because thats what what were talking about here. Thats a complication that occurred in her delivery and cocaine.
Which is another thing that she used during pregnancy is not associated with shoulder dystocia. So were down to two age or the diabetes well she delivered at 38 weeks so thats term and gestational age tends to happen gestational age is related to shoulder dystocia when its post dates so for example if you were greater than 40 weeks this gestation so 38 weeks doesnt really fall into that category so by a process of elimination is gestational diabetes. But we already know that because she can have a baby thats large overweight.
And that can lead to a very difficult delivery. Which leads to this complication next one a 29 year old preemie gravid woman at 34 weeks gestation comes to the physician for a prenatal visit at 28 weeks. She failed her 50 gram.
One hour glucose tolerance test. She also failed her follow up 100 gram. Three hour.
Glucose tolerance test with a normal fasting glucose. But abnormal 1 2.
3. Our values over the past several weeks. She has maintained good control of her fasting and to our postprandial glucose levels by adhering to the diet recommendations of her physician.
She asks the physician. What effect her diet her type of diabetes can have on her and or her fetus. Which of the following is the most appropriate response well shes basically saying you know ive got this gestational diabetes.
What what is that going to do to me and my fetus well the theres two big things. The first one of course is that can abate a baby can be macro sonic. It can be macrosomia of the fetus.
Which is defined as a large baby in this weight range and the second one i guess this theres three. I guess because this sort of macrosomia can lead to a complication known as shoulder dystocia because of the baby being so large this problem can occur during vaginal delivery. But another issue that can happen i guess in her at least of course are referring to her fetus.
But what can happen in her is that after the pregnancy. She can develop diabetes. So this would be what we call overt diabetes.
Meaning diabetes. When shes not pregnant well theyd be right here see so gestational diabetes. Is not associated with future diabetes.
Thats clearly wrong because we say that it is of course. .
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