30-year-old G3P2 patient visits an antenatal clinic at 20 weeks. She reveals during history that her first baby was 4.6 kg delivered by cesarean section, second baby was 4-8 kg delivered by c/section. Gynaecologists suspects gestational diabetes and orders a GCT. The blood sugar levels after 50 gms of oral glucose are 206 mg/dl and the patient is thus confirmed as a case of gestational diabetes. All of the following are known complications of this condition except:
In the question, patient is presenting to the antenatal clinic at 20 weeks and is diagnosed as a case of gestational diabetes.
Note: Patients blood sugar levels after 50 gms of glucose i.e. after glucose challenge test are 206 mg/dl. Recall that if, after GCT blood sugar values are ≥ 200 mg/dl, there is no need for further testing by GTT and patient is diagnosed as a case of gestational diabetes.
As discussed in the text – in gestational diabetes, blood sugar levels are raised beyond 20-24 weeks of pregnancy, due to insulin resistance and hence free radicals (responsible for causing congenital malformations) are formed after 20-24 weeks and therefore it does not lead to congenital malformation as organogenesis is already complete by this age. Rest all options are complications of diabetes.
Susceptibility for infection
Fetal hyperglycemia
Congenital malformations in fetus
Neonatal hypoglycemia