A 32-Year-Old Woman Comes to the Office for Preconceptual Counseling

question 754

Multiple Choice

A 32-year-old woman comes to the office for preconceptual counseling due to a history of insulin-controlled gestational diabetes mellitus during her previous pregnancy 2 years ago.  The pregnancy ended with a cesarean delivery for arrest of descent.  There were no postpartum complications and the insulin was discontinued after delivery.  A glucose tolerance test at the postpartum visit was normal.  The patient has no chronic medical conditions.  Medications include a prenatal vitamin and oral contraceptives.
Blood pressure is 130/80 mm Hg and pulse is 82/min.  BMI is 29 kg/m².  The remainder of the physical examination is normal.
The patient asks about her risk of diabetes mellitus (DM) in her next pregnancy.  Which of the following is the most appropriate statement about this patient's risk of recurrence?

• A)Postpartum testing was normal; therefore, the risk of recurrent gestational DM is low.
• B)There is a high risk for type 2 DM that requires first-trimester screening.
• C)There is an average risk for gestational DM that requires third-trimester screening only.
• D)There is no risk of gestational DM if a preconception hemoglobin A1c is normal.
• E)There is no risk of recurrent gestational DM; there is an increased risk for type 2 DM.

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Definitions:

Excessive Disclosure

Excessive disclosure refers to the sharing of too much personal information or details, which can be inappropriate for the context or relationship and may lead to discomfort or boundary issues.

Pressurizes Clients

The practice of applying undue influence or stress on clients, often aiming to prompt a decision or action that might not be in their best interest.

Interrupts Frequently

The act of regularly breaking the continuity of speech or a process before it is finished.

Fosters Dependency

Encouraging a reliance or strong need for support, assistance, or control by another individual or group, potentially hindering independence.