Which of the following may be a complication of normal pregnancy?

MP NHM CHO-2024 (Shift-1)

Obstetrics and Midwifery Nursing

Easy

Appeared in: MP NHM CHO-2024 (Shift-1)

Explanation

Gestational Diabetes Mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy.
Pregnancy is considered a 'diabetogenic' state because placental hormones create insulin resistance.
GDM occurs when the mother's pancreas is unable to produce sufficient additional insulin to overcome this resistance, leading to elevated blood glucose levels.
While it typically resolves after delivery, women with GDM have an increased risk of developing type 2 diabetes later in life.

Option B: A mild drop in blood pressure is a common and normal physiological adaptation during the first and second trimesters of pregnancy due to hormone-induced vasodilation. It is not considered a pathological complication.
Option C: Cataract is the clouding of the eye's lens. It is primarily associated with aging, trauma, or chronic diseases like long-standing diabetes, and is not a complication caused by pregnancy.
Option D: Retinitis pigmentosa is a group of inherited genetic disorders that cause progressive vision loss. It is not caused by or related to pregnancy.

Visual 1: Flowchart: Pathophysiology of Gestational Diabetes Mellitus. This visual can illustrate how placental hormones lead to insulin resistance, and how the failure of pancreatic compensation results in hyperglycemia.
Visual 2: Infographic: Risks to Mother and Fetus from Uncontrolled GDM. This can summarize key risks such as macrosomia, birth injury, neonatal hypoglycemia for the baby, and pre-eclampsia and future Type 2 DM for the mother.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Pregnancy as background academic context rather than a clinical decision trigger.
Nurses are central to managing GDM through patient education on blood glucose self-monitoring, diet, exercise, and medication administration (if required).
Effective nursing care helps empower the patient to take control of her condition, reducing anxiety and improving maternal and fetal outcomes.
What if? If a woman with GDM has poorly controlled hyperglycemia, the risk of fetal macrosomia (birth weight greater than 4 kg) increases significantly. This elevates the risk of shoulder dystocia, birth injuries, and the need for a Cesarean delivery.

How to Approach the Question

First, analyze the question to identify the key concept. The question asks for a 'complication' of 'normal pregnancy'. This means you are looking for a pathological condition that can arise as a result of the physiological changes of pregnancy.
Evaluate each option against this concept.
Option A, Gestational Diabetes, is a condition specifically defined by its onset during pregnancy. This makes it a strong candidate.
Option B, Low blood pressure, is a common physiological change in pregnancy, not typically classified as a complication unless severe.
Options C (Cataract) and D (Retinitis pigmentosa) are eye conditions unrelated to the physiological processes of pregnancy. Retinitis pigmentosa is genetic, and cataracts are usually age-related.
By eliminating the options that are either normal physiological changes or unrelated conditions, you can identify Gestational Diabetes as the correct answer.

Concept Tested & Keywords

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