Preconception counseling is critical to the outcome of diabetic pregnancies because poor glycemic control before and during early pregnancy is associated with:
a. Frequent episodes of maternal hypoglycemia.
b. Congenital anomalies in the fetus.
c. Polyhydramnios.
d. Hyperemesis gravidarum.
B
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A Frequent episodes of maternal hypoglycemia may occur during the first trimester (not before conception) as a result of hormone changes and the effects on insulin production and usage.
B Preconception counseling is particularly important because strict metabolic con-trol before conception and in the early weeks of gestation is instrumental in de-creasing the risks of congenital anomalies.
C Hydramnios occurs about 10 times more often in diabetic pregnancies than in nondiabetic pregnancies. Typically it is seen in the third trimester of pregnancy.
D Hyperemesis gravidarum may exacerbate hypoglycemic events because the de-creased food intake by the mother and glucose transfer to the fetus contribute to hypoglycemia.
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