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    Obesitas, DM Gestasional Dan Kehamilan

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    Yogi Anjasmara
    This document discusses obesity, gestational diabetes, and pregnancy. It notes the increasing rates of obesity in developed countries outside of Japan and provides definitions for overweight and obesity based on BMI. It then discusses how obesity can increase risks of death, diabetes, appendicitis, and accidents. The document outlines how gestational diabetes develops and affects the fetus. It provides guidelines for screening and diagnosing gestational diabetes and classifies the condition based on factors like onset and treatment needed. The impacts on pregnancy, delivery, postpartum period, and newborn are summarized. Treatment approaches during pregnancy are also covered.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Obesitas, DM Gestasional Dan Kehamilan

    Uploaded by

    Yogi Anjasmara
    9 views20 pages
    This document discusses obesity, gestational diabetes, and pregnancy. It notes the increasing rates of obesity in developed countries outside of Japan and provides definitions for overweight and obesity based on BMI. It then discusses how obesity can increase risks of death, diabetes, appendicitis, and accidents. The document outlines how gestational diabetes develops and affects the fetus. It provides guidelines for screening and diagnosing gestational diabetes and classifies the condition based on factors like onset and treatment needed. The impacts on pregnancy, delivery, postpartum period, and newborn are summarized. Treatment approaches during pregnancy are also covered.

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    Original Title

    Dm Hipertiroid

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    This document discusses obesity, gestational diabetes, and pregnancy. It notes the increasing rates of obesity in developed countries outside of Japan and provides definitions for overweight and obesity based on BMI. It then discusses how obesity can increase risks of death, diabetes, appendicitis, and accidents. The document outlines how gestational diabetes develops and affects the fetus. It provides guidelines for screening and diagnosing gestational diabetes and classifies the condition based on factors like onset and treatment needed. The impacts on pregnancy, delivery, postpartum period, and newborn are summarized. Treatment approaches during pregnancy are also covered.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    9 views20 pages

    Obesitas, DM Gestasional Dan Kehamilan

    Uploaded by

    Yogi Anjasmara
    This document discusses obesity, gestational diabetes, and pregnancy. It notes the increasing rates of obesity in developed countries outside of Japan and provides definitions for overweight and obesity based on BMI. It then discusses how obesity can increase risks of death, diabetes, appendicitis, and accidents. The document outlines how gestational diabetes develops and affects the fetus. It provides guidelines for screening and diagnosing gestational diabetes and classifies the condition based on factors like onset and treatment needed. The impacts on pregnancy, delivery, postpartum period, and newborn are summarized. Treatment approaches during pregnancy are also covered.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 20

    OBESITAS, DM GESTASIONAL

    DAN KEHAMILAN
    OBESITAS DI NEGERI MAJU
    BUKAN JEPANG

    OVERWEIGHT-BMI 25 29,9
    OBESITY BMI > 30
    ANGKA KEMATIAN PADA
    WANITA > PRIA OBESE
    1/3 ORANG AMERIKA OBESE + DM 4 X >
    25 % WANITA AMERIKA + APPENDICITIS 2 X
    OVERWEIGHT, 25 % OBESE
    + KECELAKAAN >
    MENINGKAT TERUS DALAM 100
    TAHUN TERAKHIR-TIDAK
    BERHASIL DITURUNKAN SEPERTI
    MMR DI INDONESIA
    Diabetes Mellitus
    Metabolisme karbohidrat dalam kehamilan
    Insulin ibu tdk dpt mencapai janin
    Timbul Resistensi Insulin
    Produksi rendah, Reseptor rusak
    Mengakibatkan Hipoinsulin Ibu
    Timbullah keadaan Hiperglikemi
    Diabetes dalam Kehamilan
    Timbul Hiperinsulin Janin
    THE PHYSIOLOGIC FEEDBACK LOOP
    OBESITY ( LEPTIN RESISTANCE)
    FOOD INTAKE
    ENERGY EXPENDITURE

    FAT PANCREAS
    CELLS

    LEPTIN
    - HYPOTHALAMUS
    (NPY AND OTHERS)
    - SYMPATHETIC NERVOUS
    SYSTEM
    INSULIN
    PENAPISAN DM GESTASIONAL
    Low Risk
    Blood glucose testing not routinely required if all of the following characteristics are
    present :
    Member of an ethnic group with a low prevalence of gestational diabetes
    No known diabetes in first degree relatives
    Age less than 25 years
    Weight normal before pregnancy
    No history of abnormal glucose metabolism
    No history of poor obstetrical outcome
    Average Risk
    Perform blood glucose testing at 24 28 weeks using one of the following :
    Average risk women of Hispanic, African, Native American, South of East Asian
    origins
    High risk women with marked obesity, strong family history of type 2 diabetes, prior
    gestational diabetes, or glucosuria
    High Risk
    Perform blood glucose testing as soon as feasible : If gestational diabetes is not
    diagnosed, blood glucose testing should be repeated at 24 28 weeks or at any time
    a patient has symptoms or signs suggestive of hyperglycemia
    SKRINING
    WANITA RISIKO TINGGI
    24-28 MINGGU
    50 G LOADING
    GLUKOSA PLASMA > 140 G%
    DILANJUTKAN DENGAN TTGO
    U/ DIAGNOSIS
    DIAGNOSIS: TTGO
    100 G BUKAN 75 G
    GLUKOSA PLASMA
    PUASA
    1 JAM

    2 JAM

    3 JAM
    DIAGNOSIS DM GESTASIONAL

    Plasma Glucose ( mg/dL )a


    Timing of
    National Diabetes
    Measurement Carpenter and
    Data Group
    Coustan ( 1982 )
    ( 1979 )
    Fasting 105 95

    1 hr 190 180

    2 hr 165 155

    3 hr 145 140
    BATASAN DAN KLASIFIKASI
    DM GESTASIONAL
    GANGGUAN TOLERANSI GLUKOSA BERBAGAI TINGKAT YANG MUNCUL ATAU DIDIAGNOSIS
    PERTAMA KALI SAAT KEHAMILAN

    2-HOUR
    FASTING PLASMA
    CLASS ONSET POSTPRANDIAL THERAPY
    GLUCOSE
    GLUCOSE
    A1 GESTATIONAL < 105 mg/Dl < 120 mg/dL DIET
    A2 GESTATIONAL > 105 mg/dL > 120 mg/dL INSULIN
    VASCULAR
    CLASS AGE OF ONSET(yr) DURATION (yr) THERAPY
    DISEASE
    B OVER 20 < 10 NONE INSULIN
    C 10 19 10 19 NONE INSULIN
    BENIGN
    D BEFORE 10 > 20 INSULIN
    RETINOPATHY
    F ANY ANY NEPHROPATHYa INSULIN
    PROLIFERATIVE
    R ANY ANY INSULIN
    RETINOPATHY
    H ANY ANY HEART INSULIN
    Pengaruh terhadap kehamilan
    Preeklampsi
    Hidramnion
    Kelainan letak janin
    Abortus
    Partus Prematurus
    Pengaruh terhadap Persalinan
    Inertia uteri
    Distosia bahu
    IUFD
    Infeksi meningkat
    SC meningkat
    MMR meningkat
    Pengaruh terhadap Nifas
    Infeksi nifas
    Sepsis
    Wound Dehiscene
    Pengaruh terhadap Janin
    Cacat Bawaan
    IUFD
    Dismaturitas
    Makrosomia
    Kematian Noenatal
    RDS
    PENATALAKSANAAN
    OBSTETRIS
    BISA SAMPAI ATERM MAKSIMAL
    40 MINGGU
    TIDAK PERLU MENCARI
    KELAINAN BAWAAN JANIN
    Waspada MAKROSOMIA
    PERVAGINAM, SC A/I
    OBSTETRIS
    Komplikasi
    MAKROSOMIA DG SEGALA
    AKIBATNYA:
    DISTOSIA BAHU O/K VISEROMEGALI
    TRAUMA PERSALINAN

    JAUNDICE

    SC MENINGKAT

    DM nyata pada ibu


    Obesitas dan DM nyata pada bayi
    MAKROSOMIA
    Hipertiroid dalam Kehamilan
    Merupakan Hiperfungsi kelenjar Gondok
    ( Tiroid )
    Insiden : 0,2 % kehamilan
    Sering mengalami :
    - Gangguan Haid
    - Infertilitas
    Klinis
    Exopthalmus
    Tremor
    Berdebar - debar
    Takikardi
    Metabolisme basal meningkat
    Hormon Tiroksin meningkat
    Diagnostik
    Adanya kelenjar gondok
    Klinis
    Laboratoris
    TSHS, T3 dn FT4
    Penatalaksanaan
    Medis
    - PTU
    - Lugol
    - Propanolol
    Persalinan
    - Pervaginam
    - SC ai obstetris

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