妊娠合并肝炎 糖尿病医学课件.ppt

Treatment Plasma glucose level target: 30’ before three meals 5.3 mmol/L 2h after three meals 6.7 mmol/L * Treatment Obstetrical management maternal evaluation Fetal evaluation growth and development, well-being(NST.CST,BPS) intrapartum managment Postpartum consequences * Key words glucose challenge test [GCT]) oral glucose tolerance test (OGTT) * 谢谢！ * * Pregnancy complicates Viral Hepatitis妊娠合并病毒性肝炎 Function of liver products and secrets proteins Play roles in metabolism of carbohydrates, lipids Synthesizes coagulation factors I, II, V, VII, VIII, IX, X and XI, as well as protein C, protein S and antithrombin. produces and excretes bile (which help the absorption of vitamin K from the diet) breakdown of insulin and other hormones Etc. * Viral hepatitis: Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E Other viruses * Symptoms of viral hepatitis * Symptoms of viral hepatitis * Hepatitis A * Hepatitis B: * Hepatitis B: * Hepatitis B: * Hepatitis C: * Hepatitis D: * Hepatitis E: * A gift an interesting website: /wiki/File:Viral_hepatitis.webm * Differential diagnosis ICP (intrahepatic cholestasis of pregnancy) HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) Acute fatty liver of pregnancy * Treatment Anti-viral therapy Medication for protection of liver Labor and delivery Breast-feeding * Prophylaxis HBV immunoprophylaxis Vaccines for people at high-risk of contacting HBV infection Mother：Be passively immunized with hepatitis B Ig(HBIg) in the third trimester (50%↓) Infant: receive combined therapy with HBIg and vaccination * Key words Vertical transmission Differential diagnosis of viral hepatitis * Gestational Diabetes Mellitus（GDM) 妊娠期糖尿病 上海交大医学院附属仁济医院妇产科 张羽 博士，副主任医师 rjzhangyu@163.com 2016年2月26日 Classification Gestational diabetes: diagnosed during pregnancy（90%） Overt diabetes during pregnancy(10%) to have diabetes before pregnancy * DM is a metabolic disorder