Early detection allows for antenatal management for better neonatal outcomes. Your patient is 32 weeks gestation, gravida 5 para 4 and after a routine ultrasound she is told her baby is very small and has IUGR. She asks you what causes this and you tell her:

Choice A reason: Congenital anomalies of the central nervous system are not a common complication of GDM, as they usually occur in the first trimester, before GDM develops. However, GDM can increase the risk of other congenital anomalies, such as cardiac defects or neural tube defects.

Choice B reason: Preterm birth is a possible complication of GDM, as it can be caused by maternal hypertension, preeclampsia, or placental abruption. However, it is not the most likely complication, as GDM can also delay the onset of labor and prolong the pregnancy.

Choice C reason: Low birth weight is not a typical complication of GDM, as it is more associated with intrauterine growth restriction (IUGR), which is caused by placental insufficiency. GDM can cause the opposite problem, which is excessive fetal growth.

Choice D reason: Macrosomia is the most common complication of GDM, as it is defined as a birth weight of more than 4,000 grams (8.8 pounds). It is caused by the excess glucose crossing the placenta and stimulating the fetal insulin production, which leads to increased fat deposition and organ enlargement. Macrosomia can increase the risk of birth trauma, shoulder dystocia, and neonatal hypoglycemia.

Choice A reason: Syphilis is not caused by a virus, but by a bacterium called Treponema pallidum. It can also be spread through unprotected sex, but it has different stages and symptoms than herpes. Syphilis can be cured with antibiotics if detected early.

Choice B reason: HIV/AIDS is caused by a virus, but not one that is related to the virus that causes chickenpox. HIV stands for human immunodeficiency virus, which attacks the immune system and can lead to AIDS (acquired immunodeficiency syndrome). HIV can be spread through unprotected sex, but also through other means such as blood transfusion or sharing needles. HIV cannot be cured, but antiretroviral therapy can help control the infection and prevent AIDS.

Choice C reason: Gonorrhea is not caused by a virus, but by a bacterium called Neisseria gonorrhoeae. It can be spread through unprotected sex, but it usually causes symptoms such as discharge, burning, or pain in the genitals, anus, or throat. Gonorrhea can be cured with antibiotics, but some strains are resistant to treatment.

Choice D reason: Herpes simplex virus is caused by a virus that is related to the virus that causes chickenpox. There are two types of herpes simplex virus: HSV-1 and HSV-2. HSV-1 usually causes oral herpes (cold sores), while HSV-2 usually causes genital herpes. However, both types can infect either area. Herpes can be spread through any form of unprotected sex, and can be transmitted even when there are no visible sores. Herpes has no cure, but antiviral medications can help reduce the frequency and severity of outbreaks.