Which factor is known to increase the risk of gestational diabetes mellitus?

Choice A reason: This is not a good intervention, as it may worsen the symptoms of faintness, dizziness, and agitation. Standing up can cause a sudden drop in blood pressure (orthostatic hypotension), which can reduce the blood flow to the brain and the fetus. This can cause lightheadedness, blurred vision, and loss of consciousness in the woman, as well as fetal distress or hypoxia.

Choice B reason: This is not a good intervention, as it may also worsen the symptoms of faintness, dizziness, and agitation. Lying supine can cause compression of the inferior vena cava (a large vein that returns blood to the heart) by the gravid uterus, which can reduce the cardiac output (the amount of blood pumped by the heart) and the blood pressure. This can cause nausea, sweating, and visual disturbances in the woman, as well as fetal distress or hypoxia.

Choice C reason: This is not a good intervention, as it may not improve the symptoms of faintness, dizziness, and agitation. Sitting down and holding the arm in a dependent position can lower the blood pressure in the arm, but not in the rest of the body. This can cause inaccurate readings of the blood pressure and delay the detection of hypotension or hypertension. This can also cause discomfort and pain in the arm due to impaired circulation.

Choice D reason: This is the best intervention, as it can relieve the symptoms of faintness, dizziness, and agitation by improving the blood flow to the brain and the fetus. Turning to the left side can reduce the pressure of the uterus on the inferior vena cava and increase the cardiac output and the blood pressure. This can also optimize the placental perfusion (the blood flow to the placenta) and the fetal oxygenation.

Choice A reason: Penicillin is not a correct option, as it is not effective against chlamydia. Penicillin is an antibiotic that works by inhibiting the cell wall synthesis of bacteria. However, chlamydia is an intracellular bacterium that does not have a cell wall and is resistant to penicillin.

Choice B reason: Acyclovir is not a correct option, as it is not effective against chlamydia. Acyclovir is an antiviral drug that works by inhibiting the DNA synthesis of viruses. However, chlamydia is a bacterium, not a virus, and is not affected by acyclovir².

Choice C reason: Doxycycline is the correct option, as it is one of the recommended medications for the treatment of chlamydia. Doxycycline is a tetracycline antibiotic that works by inhibiting the protein synthesis of bacteria. It can penetrate the cells and kill chlamydia by interfering with its growth and reproduction. The CDC recommends a 7-day course of doxycycline (100 mg orally twice a day) for the treatment of uncomplicated chlamydia infection.

Choice D reason: Podofilox is not a correct option, as it is not effective against chlamydia. Podofilox is a topical medication that works by destroying the tissue of genital warts caused by human papillomavirus (HPV). However, chlamydia is a different infection that does not cause genital warts and is not treated by podofilox.