A 37-year-old woman, gravida 2 para 1, at 30 weeks gestation comes to the office to discuss her recent laboratory work. At her last visit at 28 weeks gestation, the patient drank a solution containing 50 g of glucose, and her serum glucose was abnormally elevated an hour later. Today, she is scheduled to undergo a confirmatory 3-hour glucose test. Her pregnancy has been uncomplicated, and the patient has no chronic medical conditions. She is taking a daily prenatal vitamin. Vital signs are normal. Physical examination shows a uterine size consistent with gestational age. Fetal heart rate is 140/min. Which of the following hormones is most likely contributing to this patient's abnormal laboratory findings?

Question

A 37-year-old woman, gravida 2 para 1, at 30 weeks gestation comes to the office to discuss her recent laboratory work.  At her last visit at 28 weeks gestation, the patient drank a solution containing 50 g of glucose, and her serum glucose was abnormally elevated an hour later.  Today, she is scheduled to undergo a confirmatory 3-hour glucose test.  Her pregnancy has been uncomplicated, and the patient has no chronic medical conditions.  She is taking a daily prenatal vitamin.  Vital signs are normal.  Physical examination shows a uterine size consistent with gestational age.  Fetal heart rate is 140/min.  Which of the following hormones is most likely contributing to this patient's abnormal laboratory findings?

Quizplus · Accepted Answer

Eductional Objective: Human placental lactogen creates a fetal glucose-sparing effect by increasing maternal insulin resistance during the second and third trimesters, leading to a rise in serum glucose that helps provide adequate nutrition to the growing fetus.  Gestational diabetes occurs when the compensatory rise in maternal insulin secretion is inadequate to prevent serum glucose levels from reaching excessively high levels.

A 37-Year-Old Woman, Gravida 2 Para 1, at 30 Weeks