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What is the definition of a high risk pregnancy?
one in which the life or health of the mother or fetus is jeopardized by a disorder of condition coincidental or unique to pregnancy
What are the prenatal high risk factors for social personal?
- Low income
- low educational level
- poor diet
- excessive alcohol consumption
- initmati parrtner violence
- high BMI
- Low BMI
- age<16 and >35
- substance abuse
What are the prenatal high risk factors associated with preexsisting medical disorders?
- Diabetes mellitus
- cardiovascular disease (cardiac, HTN, thrombolembolic disease)
- Thyroid disorder
- renal disease
- All of these and take into consideration all the meds they are on to treat disease
What are the high risk factors associated with Obstetrical/previous pregnancy?
- previous stillborn
- habitual (recurrent abortion)
- Rh or blood group sensitization
What are the high risk factors associated with Ob/current pregnancy?
- Grandmultiparity > 5
- Twin gestation
- Blood incompatibilities
- trauma / substance abuse
- prelabor complications
- placenta abnormalities
How is carbohydrate metabolism normally in early pregnancy? in second half?
- early:increased insulin production and tissue sensitivity
- Second half: increased peripheral resistance to insulin
Why does the placenta produce several hormones during pregnancy to antagonize insulin? what are those hormones?
- to spare glucose for the continuously growing baby;
- Human placental lactogen*
- growth hormone
- corticotropin-releasing hormone
What is the primary concern in pregnancy with preexisting diabetes
control of blood glucose levels
How does hPL work?
affects fatty acids and glucose metabolism; promotes lipolysis, decreases glucose uptake