A 28-year-old woman has been an insulin-dependent diabetic for 10 years. At 36 weeks' gestation, she has an amniocentesis. A lecithin/sphingomyelin (L/S) ratio test is performed on the sample of her amniotic fluid
Since she is a diabetic, the 2:1 ratio obtained indicates that the fetus: 1. May or may not have immature lungs.
2. Has an intrauterine infection.
3. Has a neural tube defect.
4. Is at risk for hyperglycemia.
1
Rationale 1: The fetal lungs mature more slowly in diabetics, especially those on insulin. After birth, infants of diabetic mothers are at risk for hypoglycemia, not hyperglycemia.
Rationale 2: An intrauterine infection would create cloudy amniotic fluid, with the presence of white blood cells.
Rationale 3: Neural tube defects are screened with the maternal serum alpha-fetoprotein test, and diagnosed with ultrasound.
Rationale 4: After birth, infants of diabetic mothers are at risk for hypoglycemia, not hyperglycemia.
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