Complications of pregnancy: neonatal hypoglycaemia in diabetic mothers: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

OBG · Complications of pregnancy: neonatal hypoglycaemia in diabetic mothers

Sample item

A baby of a mother with poorly controlled diabetes is jittery with a blood glucose of 25 mg/dL one hour after birth. Which mechanism explains the hypoglycaemia?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Fetal islet hyperplasia with persisting hyperinsulinaemia

Maternal hyperglycaemia crosses the placenta, and the fetal pancreas responds with beta-cell hyperplasia and hyperinsulinaemia. After cord clamping the glucose infusion stops abruptly while insulin remains high, causing hypoglycaemia in the first hours. Insulin itself does not cross the placenta.

Option by option

  • A. Failure of neonatal gluconeogenesis due to deficient glucagon secretion

    Glucagon is normally secreted in the neonate, and the problem is excess insulin.

  • B. Excess neonatal cortisol suppressing the pancreatic beta cells

    Excess cortisol would cause hyperglycaemia, not hypoglycaemia.

  • C. Fetal islet hyperplasia with persisting hyperinsulinaemia (correct)

    Correct. Fetal hyperinsulinism continues after the supply of maternal glucose is cut off.

  • D. Placental transfer of large amounts of maternal insulin to the fetus

    Maternal insulin does not cross the placenta in significant amounts.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Fetal islet hyperplasia with persisting hyperinsulinaemia. Maternal hyperglycaemia crosses the placenta, and the fetal pancreas responds with beta-cell hyperplasia and hyperinsulinaemia.

Why is "Failure of neonatal gluconeogenesis due to deficient glucagon secreti…" not the answer?

Glucagon is normally secreted in the neonate, and the problem is excess insulin.

Why is "Excess neonatal cortisol suppressing the pancreatic beta cells" not the answer?

Excess cortisol would cause hyperglycaemia, not hypoglycaemia.

Why is "Placental transfer of large amounts of maternal insulin to the fetus" not the answer?

Maternal insulin does not cross the placenta in significant amounts.

What concept does this question test?

It tests Complications of pregnancy: neonatal hypoglycaemia in diabetic mothers in OBG. After cord clamping the glucose infusion stops abruptly while insulin remains high, causing hypoglycaemia in the first hours. Insulin itself does not cross the placenta.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications of pregnancy: neonatal hypoglycaemia in diabetic mothers?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.