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Gynaecology & Obstetrics General 2ca6aac2

All are the effects of gestational diabetes on fetus EXCEPT:

A
Macrosomia
B
Hypoglycemia
C
Congenital malformations
D
Increased Perinatal Moality
High-Yield Explanation
Hypoglycemia REF: Current Diagnosis & Treatment Obstetrics & Gynecology, 10th edition chapter 18, Willians 22nd edition Table 52-8, http://en.wikipedia.org/wiki/Gestational diabetes (Note: Chromosomal abressions are not seen in gestational diabetes but congenital malformations are seen) Neonates of diabetic mother are at an increased risk of low blood glucose (hypoglycemia), jaundice, high red blood cell mass (polycythemia) and low blood calcium (hypocalcemia) and magnesium (hypomagnesemia) The fetus continues to experience the effects of hyperglycemia beyond the period of organogenesis. Whereas glucose crosses the placenta, insulin does not, leading to increased fetal production of insulin to compensate for its hyperglycemic environment. Higher insulin levels promote increased fetal somatic growth, leading not only to macrosomia and central fat deposition but also to enlargement of internal organs such as the hea. CONGENITAL MALFORMATIONS IN INFANTS OF WOMEN WITH DIABETES Anomaly Ratios of Incidencea Caudal regression Situs inversus Spina bifida, hydrocephaly, or other central nervous system defect Anencephaly 252 84 2 3 Hea anomalies Atrial septal defects Ventricular septal defects Transposition of the great vessels Coarctation of the aoa Tetralogy of Pallot Truncus aeriosus Dextrocardia Cardiomegaly 4 Anal/rectal atresia 3 Renal anomalies 5 Agenesis 4 Cystic kidney 4 Duplex ureter 23 'Ratio of incidence is in comparision with the general population.

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