Question

What is true about a diabetic pregnancy?

• A. Cardiovascular anomalies are the most commonly seen congenital anomalies
• B. Dexamethasone is contraindicated since it causes hyperglycemia
• C. Screening for Down syndrome is not effective
• D. Beta agonists are contraindicated in preterm labor

Hint:

Cardiac defects are the most frequent congenital anomalies in infants of diabetic mothers, though caudal regression is the most specific one.

Answer 1

The Correct Option is A

Step 1: Understanding the Question.
We need to pick the one true statement about pregnancy in a diabetic mother, covering fetal anomalies, steroid use, Down syndrome screening, and tocolytic drug choice.

Step 2: Key Concept or Approach.
Babies of diabetic mothers, called infants of diabetic mothers, carry a higher risk of congenital malformations because high blood sugar around the time of conception disturbs early organ formation. The malformations can affect many systems, and their overall frequency across systems decides which one is called the "most common", while a different malformation can be the one that is most specific to diabetes.

Step 3: Detailed Explanation.
Across all organ systems, cardiovascular malformations such as septal defects and transposition of the great vessels turn out to be the most frequently seen anomalies in infants of diabetic mothers, even though caudal regression syndrome (sacral agenesis) is the finding most specific to diabetes, because it is rarely seen in any other setting. So option (A) is a true and standard teaching point.
Dexamethasone or betamethasone is given in a diabetic pregnancy when the fetal lungs need to mature before an early delivery. It does raise maternal blood sugar for a few days, but this is managed with closer glucose monitoring and adjusted insulin doses, it is not an absolute contraindication. So option (B) overstates the caution.
Down syndrome screening in a diabetic mother still works. Some biochemical markers used in the first or second trimester test, such as AFP and hCG, run a little different in diabetic women, so labs apply a correction factor for maternal weight and diabetes status, but the screening itself remains useful, it is not ineffective. So option (C) is false.
Beta agonists such as terbutaline are used with caution in diabetic women for stopping preterm labor because they can push blood sugar up and, rarely, precipitate ketoacidosis, but this is a relative caution calling for tighter glucose control, not an absolute contraindication. So option (D) overstates the restriction.

Step 4: Final Answer.
The one statement that holds up as stated is that cardiovascular anomalies are the most commonly seen congenital anomalies in a diabetic pregnancy.
\[ \boxed{\text{Cardiovascular anomalies are the most common}} \]