A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should concern her nurse?

Choice A: February 6-7 is incorrect. This is too late for the woman's fertile period, which occurs around the time of ovulation. Ovulation usually happens about 14 days before the next period starts, which would be around January 22 for a 28-day cycle¹.

Choice B:In a 28-day menstrual cycle, ovulation typically occurs around day 14 (counting from the first day of the last menstrual period). Since the first day of the last period is January 8, day 14 falls on January 22. The fertile window consists of the five days leading up to ovulation and the day of ovulation (January 17–22), as sperm can survive in the reproductive tract for up to 5 days, and the egg remains viable for about 24 hours after ovulation.January 22-23 is the most fertile period, with ovulation occurring around January 22 and the egg remaining viable for fertilization on January 23.

Choice C: January 30-31 is incorrect. This is after the woman's fertile period, which ends about a day after ovulation. Ovulation usually happens about 14 days before the next period starts, which would be around January 22 for a 28-day cycle.

Choice D: January 14-15 corresponds to cycle days 7-8, which is too early for ovulation in a typical 28-day cycle. Ovulation generally occurs around day 14 (January 22). The follicular phase (the first half of the cycle) is when the follicles in the ovary mature, and estrogen levels rise to trigger ovulation. At this point (January 14-15), the egg is not yet released, and the uterus is still preparing for ovulation, making conception unlikely.

Choice A reason: A previous birth of a large infant (macrosomia) is a risk factor for gestational diabetes mellitus (GDM). A large infant may indicate that the mother had high blood glucose levels during pregnancy, which can cause the fetus to grow larger than normal. Women who have had a large infant are more likely to develop GDM in subsequent pregnancies.

Choice B reason: Underweight before pregnancy is not a risk factor for GDM. In fact, being overweight or obese before pregnancy is a risk factor for GDM, as it increases insulin resistance and makes it harder for the body to use glucose effectively.

Choice C reason: A previous diagnosis of type 2 diabetes mellitus is not a risk factor for GDM. It is a contraindication for GDM, as it means that the woman already has diabetes before pregnancy. GDM is a condition that develops during pregnancy and usually resolves after delivery.

Choice D reason: Maternal age younger than 25 years is not a risk factor for GDM. In fact, being older than 25 years is a risk factor for GDM, as it increases the risk of insulin resistance and other metabolic changes that can affect glucose tolerance.