3.         A 34-year-old unbooked primigravida has delivered the baby in your hospital.

a)         How would you describe this baby?

            Macrosomic.

b)         What condition is the mother likely to have?

            Gestational diabetes mellitus that is poorly controlled.

c)         The baby is in the neonatal unit. Name 3 problems you would be looking for.

            Respiratory distress syndrome, polycythaemia, hypothermia.

d)            Describe the physiological process likely to cause this condition in this baby?

            High maternal sugar levels pass to the fetus which respond by increasing insulin production. Insulin acts as a growth factor causing organomegaly leading to macrosomia.

e)         What one important test would you do for the mother of the child and when?

            Do a OGTT at 6 weeks after delivery.