Preconception counseling is critical to the outcome of diabetic pregnancy because poor glycemic control before and during early pregnancy is associated with:
1. frequent episodes of maternal hypoglycemia.
2. congenital anomalies in the fetus.
3. polyhydramnios.
4. hyperemesis gravidarum.
2
1. Incorrect. Frequent episodes of maternal hypoglycemia may occur during the first tri-mester (not before conception) as a result of hormone changes and the effects on insulin production and usage.
2. Correct. Preconception counseling is particularly important because strict metabolic control before conception and in the early weeks of gestation is instrumental in decreasing the risks of congenital anomalies.
3. Incorrect. Hydramnios occurs about 10 times more often in diabetic than in nondiabetic pregnancies. Typically, this is seen in the third trimester of pregnancy.
4. Incorrect. Hyperemesis gravidarum may exacerbate hypoglycemic events because the decreased food intake by the mother and glucose transfer to the fetus contribute to hypogly-cemia.
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