You are on page 1of 3

ELKA RIFQAH 130110110148 EMS – E2

GESTATIONAL DIABETES
DEFINITION
Gestational Diabetes (GDM) is defined as glucose intolerance that develops or is first recognized during pregnancy. As insulin resistance increases during pregnancy, euglycemia depends on a compensatory increase in insulin secretion. Failure to compensate with increased insulin secretion leads to gestational diabetes.

ETIOLOGY
Apotential etiology for gestational diabetes mellitus (GDM) is a limitation in β-cell reserves that manifests as hyperglycemia when insulin secretion does not increase to match the escalated insulin needs during pregnancy

RISK FACTOR

EFFECTS (COMPLICATION)
The effects of gestational diabetes in diabetes mellitus mother to the fetus 1. Risk of Spontaneous abortion  1st trimester 2. Congenital malformation  Incidence : 6-12% in infants whose mothers had poor diabetes control and 2% in infants whose mothers with diabetes with normal glycohemoglobin levels or normal mother.  Fetal and neonatal deaths reached 50%. The ratio of incidence in The oldest Gestational Age diabetic vs normal group to Happen (weeks)

Caudal regradation

252

5

Not only due to the concentration of glucose or other solvents in excess of amniotic fluid or fetal urine. hydrocephalus 2 or other CNS defects Heart anomali Large vessel transportation Ventricular septal defect Atrium septum caudal Anal/rectal atresia Kidney anomali agenesis Cystic kidney Duplex ureter Situs inversus 3 5 6 4 23 84 7 7 7 6 4 7 8 8 8 3. decidual and amniotic prolactin. Fetal distress  3rd trimester 7. 5. doing an ultrasound to detect Congenital Heart Defect. Respiratory distress syndrome (RDS)  Children of mothers with poor control of diabetes usually have a higher risk of having RDS.ELKA RIFQAH 130110110148 EMS – E2 anencephaly 3 6 6 Spina bifida. Polihidramnion  2nd trimester   amniotic fluid volume excess (> 1000 ml.  At week 26 and 36 required tests to measure the growth and health of the fetus. often> 3000 ml). . but also because of decreased fetal swallowing. 4. also unknown determinants of the complicated multicompartemantal intrauterine transport of water. at 14-16 weeks should be examined increases serum α-fetoprotein.  At 18-22 weeks. Premature birth 6. Neural Tube Defect  Incidence : higher in infants whose mothers with poor diabetic control  In pregnant women with insulin-dependent.

Hypoglycemia (blood glucose <30 mg / dL)  Generally occurs in the first 48 hours after birth. and there is difficulty breathing for> 48 hours with no other cause identified.  Symptomps: lethargic rather than Jittery. typical findings on Xray.extract . an increase in the ratio of abdominal-head or thorax-head ratio and concentrations of C-peptide in sera or amniotic fluid cold higher. 16.org/content/34/1/e8. 8. apnea. Therapy: intrapulmonary ventilation and surfactant administration.diabetesjournals. Intrauterine Growth Delay (IUGR)  Occurs in pregnant diabetics with long duration and have vascular disease. Source :  Greenspan’s basic and clinical endocrinology 9th ed 2011  http://care. 14.  Etiology: increased fetal insulin levels after birth and decrease catecholamines and glucagon due to lack of glucose production by the liver and FFA oxidation. 12. cyanosis. convulsions (seizures)  Treatment: give 10% dextrose in water bottles preformance at the age of 1 hour. Hyperbilirubinemia (> 15 mg / dL) Hypocalcaemia (<7 mg / dL) Polysitemia (central hematocrit> 70%) feeding disorders Intrauterine death Risk factors: • 50% of women with ketoacidosis • pyelonephritis • Fetal hyperglycemia and hipoxia leads to acidosis and myocardial dysfunction. 13.  This is due to maternal hyperglycemia  fetal hyperglycemiafetal hyperinsulinemiafetal macrosomia 9. retractions.ELKA RIFQAH 130110110148 EMS – E2    Etiology: abnormal production of surfactant and connective tissue changes resulting in decreased compliance (flower power) of the lung.  Related to inadequate uteroplacental perfusion 11. RR <60/min). tachypnea. Vaginal birth trauma 10. and when it does not work given dextrose intravenous fluids. Fetal macrosomia (Birth weight> 90th percentile)  Fetus whose mothers with poor diabetes control most experienced macrosomia with many fat deposits. 15. increase in body length. Diagnosis based on: clinical symptoms (grunting.