A placenta previa in which the placental edge just reaches the internal os is more commonly known as:

Choice A reason: Maternal placenta previa is not a common complication of gestational diabetes mellitus. Placenta previa is a condition in which the placenta covers the cervix, which can cause bleeding and preterm labor. The risk factors for placenta previa include previous cesarean delivery, multiple pregnancy, advanced maternal age, and smoking.

Choice B reason: Maternal hyperemesis and neonatal low birth weight are not directly related to gestational diabetes mellitus. Hyperemesis is a severe form of nausea and vomiting during pregnancy that can cause dehydration and weight loss. The causes of hyperemesis are not well understood, but it may be influenced by hormonal changes, genetic factors, and psychological factors². Neonatal low birth weight is defined as a birth weight of less than 2,500 grams, which can be caused by many factors, such as prematurity, intrauterine growth restriction, maternal infection, and maternal malnutrition.

Choice C reason: Maternal premature rupture of membranes and neonatal sepsis are not specific to gestational diabetes mellitus. Premature rupture of membranes is a condition in which the amniotic sac breaks before labor begins, which can increase the risk of infection and preterm delivery. The causes of premature rupture of membranes are not clear, but some possible factors include infection, inflammation, stress, and trauma. Neonatal sepsis is a life-threatening infection in newborns, which can be caused by bacteria, viruses, or fungi. The risk factors for neonatal sepsis include prematurity, low birth weight, maternal infection, and invasive procedures⁵.

Choice D reason: Maternal preeclampsia and fetal macrosomia are the most common and serious complications of gestational diabetes mellitus. Preeclampsia is a condition characterized by high blood pressure and protein in the urine, which can lead to organ damage, seizures, and death. The exact cause of preeclampsia is unknown, but it may be related to abnormal placental development, immune system dysfunction, and genetic factors⁶. Fetal macrosomia is a condition in which the baby is larger than normal, usually weighing more than 4,000 grams at birth. This can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, and cesarean section. The main cause of fetal macrosomia is excessive maternal glucose, which stimulates fetal insulin production and growth.

Choice A reason: The NST has no known contraindications, as it is a non-invasive and safe test that does not stimulate uterine contractions or cause fetal distress. It is the most widely used method of antepartum fetal surveillance.

Choice B reason: The NST is not slightly more expensive than the CST, as it requires less time and equipment. The NST usually takes 20 to 40 minutes, while the CST may take up to 2 hours. The NST only needs a fetal monitor, while the CST also needs an intravenous line and oxytocin infusion.

Choice C reason: The NST does not have fewer false-positive results than the CST, as it has a higher rate of nonreactive results that may indicate fetal compromise when there is none. A nonreactive NST is one that does not show at least two accelerations of the fetal heart rate of 15 beats per minute or more lasting 15 seconds or more in a 20-minute period.

Choice D reason: The NST is not more sensitive in detecting fetal compromise than the CST, as it has a lower predictive value for fetal well-being. A reactive NST is one that shows at least two accelerations of the fetal heart rate of 15 beats per minute or more lasting 15 seconds or more in a 20-minute period. However, a reactive NST does not rule out the possibility of fetal hypoxia or acidosis.