A 25-year-old single woman comes to the gynecologist's office for a follow-up visit related to her abnormal Papanicolaou (Pap) smear. The test revealed that the patient has human papillomavirus (HPV). The patient asks, "What is that? Can you get rid of it?" Your best response is:

Choice A reason: Insulin is the preferred medication for gestational diabetes mellitus, as it does not cross the placenta and has no adverse effects on the fetus. It can be administered subcutaneously or intravenously, depending on the blood glucose level and the type of insulin.

Choice B reason: Glipizide is an oral antidiabetic agent that belongs to the sulfonylurea class. It stimulates the pancreas to secrete more insulin and lowers the blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cross the placenta and cause hypoglycemia, macrosomia, or teratogenic effects on the fetus.

Choice C reason: Acarbose is an oral antidiabetic agent that belongs to the alpha-glucosidase inhibitor class. It delays the absorption of carbohydrates from the intestine and reduces the postprandial blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cause gastrointestinal side effects, such as flatulence, diarrhea, or abdominal pain, and may interfere with the absorption of other nutrients.

Choice D reason: Repaglinide is an oral antidiabetic agent that belongs to the meglitinide class. It stimulates the pancreas to secrete more insulin and lowers the blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cross the placenta and cause hypoglycemia, macrosomia, or teratogenic effects on the fetus.

Choice A reason: A biophysical profile score of 8 is a good indicator of fetal well-being, but it does not measure the fetal lung maturity. It consists of five parameters: fetal breathing movements, fetal movements, fetal tone, amniotic fluid volume, and nonstress test.

Choice B reason: Phosphatidylglycerol (PG) is a phospholipid that is present in the fetal lung surfactant. Its presence indicates that the fetal lungs are mature, while its absence does not rule out the possibility of maturity.

Choice C reason: Lecithin and sphingomyelin are two phospholipids that are found in the fetal lung surfactant. The L/S ratio is the ratio of lecithin to sphingomyelin in the amniotic fluid. A ratio of 2:1 or higher indicates that the fetal lungs are mature and can produce enough surfactant to prevent respiratory distress syndrome.

Choice D reason: A nonstress test is a test that measures the fetal heart rate and its response to fetal movements. A reactive test means that the fetal heart rate increases by at least 15 beats per minute for at least 15 seconds twice in a 20-minute period. This indicates that the fetus is healthy and well-oxygenated, but it does not reflect the fetal lung maturity.