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

Choice A reason: An FHR greater than 110 beats/min is not a sufficient indicator of fetal well-being during labor. The normal range of FHR is between 110 and 160 beats/min, but it can vary depending on the gestational age, fetal activity, and maternal factors. A high or low FHR may indicate fetal distress or compromise.

Choice B reason: Maternal pain control is not a direct measure of fetal well-being during labor. However, maternal pain can affect the FHR indirectly by causing maternal stress, anxiety, or hyperventilation, which can alter the blood flow and oxygen delivery to the fetus. Therefore, adequate pain management is important for both maternal and fetal health.

Choice C reason: The response of the FHR to UCs is the most reliable and accurate way of assessing fetal well-being during labor. UCs can cause temporary reductions in the blood flow and oxygen supply to the fetus, which can affect the FHR. A normal response of the FHR to UCs is either no change or a slight increase (acceleration), which indicates a well-oxygenated and resilient fetus. An abnormal response of the FHR to UCs is a decrease (deceleration), which indicates a compromised or hypoxic fetus.

Choice D reason: Accelerations in the FHR are not a definitive measure of fetal well-being during labor. Accelerations are transient increases in the FHR above the baseline, usually caused by fetal movement, stimulation, or UCs. Accelerations are generally reassuring and indicate a responsive and well-oxygenated fetus, but they are not always present or consistent. The absence of accelerations does not necessarily mean fetal distress, as some fetuses may have periods of sleep or reduced activity.

Choice A reason: This is incorrect because oral antiviral therapy is not effective for PID, which is caused by bacterial infection. Antiviral therapy is used for viral infections, such as herpes or HIV.

Choice B reason: This is incorrect because antibiotics only until symptoms subside is not sufficient for PID, which can cause serious complications, such as infertility, ectopic pregnancy, or chronic pelvic pain. Antibiotics should be continued for the full course of treatment, usually 14 days, to ensure complete eradication of the infection.

Choice C reason: This is incorrect because frequent pelvic examination to monitor the progress of healing is not recommended for PID, which can cause inflammation and irritation of the pelvic organs. Pelvic examination should be avoided or minimized to prevent further trauma or spread of the infection.

Choice D reason: This is correct because bed rest in a semi-Fowler position is beneficial for PID, which can cause fluid accumulation and pressure in the pelvic cavity. Bed rest helps to reduce inflammation and pain, while semi-Fowler position helps to drain the fluid and prevent abscess formation.