A patient with pregnancy-induced hypertension is admitted complaining of pounding headache, visual changes, and epigastric pain.

Nursing care is based on the knowledge that these signs are an indication of:

Choice A reason: Maternal placenta previa is not a common complication of gestational diabetes mellitus. Placenta previa is a condition in which the placenta covers the cervix, which can cause bleeding and preterm labor. The risk factors for placenta previa include previous cesarean delivery, multiple pregnancy, advanced maternal age, and smoking.

Choice B reason: Maternal hyperemesis and neonatal low birth weight are not directly related to gestational diabetes mellitus. Hyperemesis is a severe form of nausea and vomiting during pregnancy that can cause dehydration and weight loss. The causes of hyperemesis are not well understood, but it may be influenced by hormonal changes, genetic factors, and psychological factors². Neonatal low birth weight is defined as a birth weight of less than 2,500 grams, which can be caused by many factors, such as prematurity, intrauterine growth restriction, maternal infection, and maternal malnutrition.

Choice C reason: Maternal premature rupture of membranes and neonatal sepsis are not specific to gestational diabetes mellitus. Premature rupture of membranes is a condition in which the amniotic sac breaks before labor begins, which can increase the risk of infection and preterm delivery. The causes of premature rupture of membranes are not clear, but some possible factors include infection, inflammation, stress, and trauma. Neonatal sepsis is a life-threatening infection in newborns, which can be caused by bacteria, viruses, or fungi. The risk factors for neonatal sepsis include prematurity, low birth weight, maternal infection, and invasive procedures⁵.

Choice D reason: Maternal preeclampsia and fetal macrosomia are the most common and serious complications of gestational diabetes mellitus. Preeclampsia is a condition characterized by high blood pressure and protein in the urine, which can lead to organ damage, seizures, and death. The exact cause of preeclampsia is unknown, but it may be related to abnormal placental development, immune system dysfunction, and genetic factors⁶. Fetal macrosomia is a condition in which the baby is larger than normal, usually weighing more than 4,000 grams at birth. This can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, and cesarean section. The main cause of fetal macrosomia is excessive maternal glucose, which stimulates fetal insulin production and growth.

Choice A reason: Progesterone is the hormone that stimulates the development of the alveoli and lobules of the mammary glands during pregnancy. It prepares the breasts for lactation by increasing the number and size of the milk-producing cells.

Choice B reason: Testosterone is the main male sex hormone that is responsible for the development of male reproductive organs and secondary sex characteristics. It has no direct role in the maturation of mammary gland tissue.

Choice C reason: Prolactin is the hormone that initiates and maintains milk production after childbirth. It is secreted by the anterior pituitary gland in response to suckling or nipple stimulation. It does not affect the maturation of mammary gland tissue.

Choice D reason: Estrogen is the hormone that stimulates the growth of the duct system of the mammary glands during puberty and pregnancy. It also promotes the development of female reproductive organs and secondary sex characteristics. It does not affect the maturation of mammary gland tissue.