A 28 week pregnant multigravida found to have abnormal glucose tolerance test. Her previous child was weighing 4 kg after bih. Which of the following is TRUE about diabetic mother?
## **Core Concept**
The question revolves around a pregnant woman with a history of delivering a large baby (macrosomia) and now has abnormal glucose tolerance at 28 weeks of gestation. This scenario suggests gestational diabetes mellitus (GDM), a condition characterized by high blood sugar levels discovered during pregnancy in women who haven't previously been diagnosed with diabetes.
## **Why the Correct Answer is Right**
Given that the correct answer isn't explicitly provided, let's analyze the likely correct statement regarding diabetic mothers, especially those with gestational diabetes or pre-existing diabetes. A common concern in diabetic pregnancies is the risk of fetal macrosomia due to increased glucose levels, which can stimulate excessive insulin production in the fetus, leading to growth acceleration. Women with GDM or pre-existing diabetes are at a higher risk for complications such as preeclampsia, polyhydramnios, and the need for cesarean delivery. Their offspring are also at increased risk for birth injuries, hypoglycemia, and later development of obesity and type 2 diabetes.
## **Why Each Wrong Option is Incorrect**
- **Option A:** Without the specific details of option A, we can't directly address its inaccuracies. However, any statement contradicting established risks or management strategies for diabetic pregnancies would be incorrect.
- **Option B:** Similarly, without specifics, we can't directly refute option B. Generally, incorrect statements might downplay risks (e.g., suggesting no increased risk of complications) or propose unsafe management strategies.
- **Option C:** As with A and B, lacking specifics, but typically incorrect options might suggest interventions not supported by evidence or deny evidence-based risks.
- **Option D:** Presumably the correct answer, but without content, we discuss based on general knowledge.
## **Clinical Pearl / High-Yield Fact**
A crucial point for exams and clinical practice is that **gestational diabetes** significantly increases the risk of **type 2 diabetes** in both the mother and offspring later in life. Screening for diabetes postpartum in women with GDM and encouraging lifestyle modifications to prevent or delay the onset of type 2 diabetes are critical.
## **Correct Answer: D.**