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Gynaecology & Obstetrics General 053232e4

A 30-year-old woman with diabetes mellitus presents to her physician at 19 weeks' gestation. She is obese and did not realize that she was pregnant until recently. She also has not been "watching her sugar" lately, but is now motivated to improve her regimen. A dilated ophthalmologic examination shows no retinopathy. An ECG is normal. Urinalysis is negative for proteinuria. Laboratory studies show: Hemoglobin A 1c: 10.8% , Glucose: 222 mg/dL , Thyroid-stimulating hormone: 1.0 μU/mL, Free thyroxine: 1.7 ng/dL ,Creatinine: 1.1 mg/dL. In which of the following condition the risk of developing it is same in diabetics as the general population.

A
Asymptomatic bacteriuria
B
Preeclampsia
C
Congenital adrenal hyperplasia
D
PPH after delivery
High-Yield Explanation
In the question, patient is presenting with overt diabetes mellitus i.e. she had diabetes before pregnancy also. The question says, in which the following conditions the risk of developing the condition is same in diabetic as well as nondiabetic patients in other words, which of the options is not a complication of diabetes during pregnancy. Option ‘a’ – asymptomatic bacteriuvea – Diabetes during pregnancy, increases the chances of infections including asymptomatic bacteriuria Dutta Obs. 7/e, p 283 Option ‘b’ – preeclampsia – In all diabetic patients, there are increased chances of preeclampsia (25%) Dutta Obs. 7/e p 283 Option ‘c’ – Congenital adrenal hyperplasia – It does not have any relation whatsoever with diabetes. Option ‘d’ – PPH after delivery – Diabetic pregnancy leads to polyhydramnios which can lead to PPH after delivery. Option ‘e’ – Shoulder dystocia is a result of macrosomia during pregnancy.

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