The risk for which pregnancy complication is increased in the client with type 1 diabetes mellitus?

• A. Hypertensive disorders of pregnancy
• B. Placenta accreta
• C. Increased appetite
• D. Oligohydramnios in the third trimester

Answer: (A)

In type 1 diabetes, the combination of chronic hyperglycemia and vascular changes in the mother makes hypertensive disorders in pregnancy more likely. The high glucose levels contribute to endothelial dysfunction and increased oxidative stress, which can stiffen and narrow blood vessels. This vascular strain raises the risk of developing gestational hypertension and preeclampsia as the placenta forms and implants. Abnormal placental development in diabetic pregnancies can further disrupt placental perfusion, feeding into the cycle that elevates blood pressure during pregnancy.

Placenta accreta isn’t a typical consequence of type 1 diabetes; it’s more tied to prior uterine scarring and placenta previa. Increased appetite isn’t a complication but a symptom, and oligohydramnios in the third trimester isn’t the best fit for this scenario—diabetic pregnancies more often feature polyhydramnios due to fetal polyuria from maternal hyperglycemia, though other issues can modify amniotic fluid levels.