What are the maternal and neonatal risks associated with gestational diabetes mellitus?

Maternal placenta previa and fetal prematurity.

Maternal hyperemesis and neonatal low birth weight.

Maternal premature rupture of membranes and neonatal sepsis.

Maternal preeclampsia and fetal macrosomia.

Answer and Explanation

The Correct Answer is D

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.

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Correct Answer is B

Explanation

Choice A reason: Nonreactive is not the correct result, as it indicates that the FHR does not show adequate accelerations with fetal movement. A nonreactive NST means that the FHR does not increase by at least 15 beats/min for at least 15 seconds in a 20-minute period. A nonreactive NST may suggest fetal hypoxia (low oxygen) or fetal sleep.

Choice B reason: Reactive is the correct result, as it indicates that the FHR shows adequate accelerations with fetal movement. A reactive NST means that the FHR increases by at least 15 beats/min for at least 15 seconds twice or more in a 20-minute period. A reactive NST is reassuring and suggests that the fetus is well-oxygenated and healthy.

Choice C reason: Positive is not the correct result, as it is not used to describe the NST. Positive is a term used for the contraction stress test (CST), which is a different test that measures the FHR in response to uterine contractions. A positive CST means that the FHR shows late decelerations (decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends) with at least 50% of the contractions. A positive CST indicates uteroplacental insufficiency (a condition where the placenta does not deliver enough oxygen and nutrients to the fetus) and fetal distress.

Choice D reason: Negative is not the correct result, as it is also not used to describe the NST. Negative is another term used for the CST, which is a different test that measures the FHR in response to uterine contractions. A negative CST means that the FHR does not show any late decelerations during at least three contractions in a 10-minute period. A negative CST is reassuring and suggests that the fetus is well-oxygenated and can tolerate labor.

A. low birth weight. B. preterm birth. C. macrosomia. D. congenital anomalies of the central nervous system.

Correct Answer is C

Explanation

Choice A reason: Low birth weight is not a common complication of GDM, as the fetus tends to grow larger than normal due to the excess glucose and insulin in the blood. Low birth weight is more likely to occur in infants of mothers with preexisting diabetes or other conditions that affect placental function.

Choice B reason: Preterm birth is a possible complication of GDM, as the increased fetal size and the risk of maternal hypertension or infection may induce labor before term. However, it is not the greatest risk for the fetus, as preterm infants can survive with proper care and treatment.

Choice C reason: Macrosomia is the greatest risk for the fetus of a mother with GDM, as it is defined as a birth weight of more than 4000 g or 8 lb 13 oz. Macrosomia can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, or cesarean birth. It can also increase the risk of neonatal hypoglycemia, jaundice, or respiratory distress.

Choice D reason: Congenital anomalies of the central nervous system are not a common complication of GDM, as they usually occur in the first trimester of pregnancy, before GDM is diagnosed or develops. Congenital anomalies are more likely to occur in infants of mothers with preexisting diabetes or other genetic or environmental factors.

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What are the maternal and neonatal risks associated with gestational diabetes mellitus?

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Naxlex Comprehensive Predictor Exams

What is the result of a nonstress test (NST) in which two or more fetal heart rate (FHR) accelerations of 15 beats/min or more occur with fetal movement in a 20-minute period?

Correct Answer is B

Explanation

Correct Answer is C

Explanation

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