Medical Disorders in Pregnancy · NEET PG Preparation Obstetrics & Gynaecology
A 30-year-old G2P1 at 28 weeks of gestation with known pre-existing type 1 diabetes mellitus presents for a routine antenatal check-up. Her HbA1c at…
Practice question from Medical Disorders in Pregnancy (NEET PG Preparation Obstetrics & Gynaecology), with the correct answer and a step-by-step solution.
hard · MCQ · Q-6E90A1
A 30-year-old G2P1 at 28 weeks of gestation with known pre-existing type 1 diabetes mellitus presents for a routine antenatal check-up. Her HbA1c at booking was 8.2%. She is currently on a basal-bolus insulin regimen. Fetal growth ultrasound shows estimated fetal weight at the 95th percentile, and amniotic fluid index is 26 cm. Which of the following fetal complications is she at highest risk of developing due to her glycemic status?
- A.Neural tube defects
- B.Caudal regression syndrome
- C.Intrauterine growth restriction (IUGR)
- D.Polycythemia and neonatal hypoglycemiaCorrect answer
Solution
Poor glycemic control in the second and third trimesters leads to fetal hyperglycemia, resulting in fetal hyperinsulinemia. This drives excessive somatic growth (macrosomia), polycythemia, and hyperbilirubinemia, and places the neonate at high risk for immediate postpartum hypoglycemia due to persistent endogenous hyperinsulinemia. Neural tube defects and caudal regression syndrome are associated with first-trimester hyperglycemia, not late complications.
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