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Introduction to diabetes and other endocrinopathies

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Diabetes is the most common pre-existing medical disorder seen in pregnancy, occurring in about four pregnancies in every thousand in the UK. The tutorial will cover problems, complications and issues relating to diabetes during pregnancy.

This tutorial will also outline the physiological changes to maternal pituitary hormones and maternal and fetal thyroid hormones in pregnancy. The aim is to inform trainees of management options for the most common causes of pituitary and thyroid dysfunction.

Learning objectives

 

By completing this tutorial, you will develop your knowledge in the following four areas:

 

Diabetes during pregnancy

  • the problems and complications that might happen to pregnant women with pre-existing diabetes
  • issues relating to pre-pregnancy, antenatal, intrapartum and postnatal care of diabetes
  • how to care for women with pre-existing diabetes
  • gestational diabetes – a contentious subject confused by variable definitions and a lack of well-controlled research, which results in frequent debates in the literature as to its clinical relevance

Pituitary disorders

  • the physiological changes to maternal pituitary hormones in pregnancy
  • the treatment and management of prolactinomas in pregnancy
  • the treatment and management of hypopituitarism in pregnancy
  • the maternal and fetal risks associated with pituitary disorders in pregnancy
  • the management principles used for women with pituitary disease in pregnancy

Adrenal disorders

  • the physiological changes to maternal and fetal adrenal hormones in pregnancy
  • the pathophysiology of adrenal disease in pregnancy
  • the clinical characteristics of adrenal disorders in pregnancy and the associated maternal and fetal risks
  • the management principles used for women with adrenal disease in pregnancy

Thyroid disorders

  • the physiological changes to maternal and fetal thyroid hormones in pregnancy
  • the treatment and management of hyperthyroidism in pregnancy
  • the maternal and fetal risks associated with thyroid disorders in pregnancy
  • the management principles used for women with thyroid disease in pregnancy

Last updated: 11/11/2011 (the Endocrine section of this tutorial was reviewed and updated by Dr Rebecca Robinson and Dr George Bugg).

20/05/10 (the Diabetes section of this tutorial was reviewed and updated by Dr Suzanne Wallace)

3/02/09 (article added in the Gestational diabetes mellitus and Gestational diabetes mellitus – Further reading sections).

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