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Untreated gonorrhea in pregnant women can lead to several serious complications, one of which is pelvic inflammatory disease (PID). Gonorrhea is a sexually transmitted infection that can infect the reproductive organs, leading to inflammation and infection in the uterus, fallopian tubes, and ovaries. If this infection is not treated, it can progress to PID, which poses risks to the woman's health, including chronic pain, infertility, and an increased risk of ectopic pregnancy.

In the context of pregnancy, PID can also result in negative outcomes for the fetus, such as preterm birth, low birth weight, or even miscarriage. The link between untreated gonorrhea and PID is particularly important because pregnant women are generally advised to be screened and treated for STIs, including gonorrhea, to avoid such complications.

The other options listed do not have a direct causative relationship with untreated gonorrhea. Gestational diabetes and preeclampsia are pregnancy-related complications that occur due to factors like metabolic and cardiovascular changes during pregnancy and are not caused by gonorrhea. Ectopic pregnancy can have multiple causes, but while it can be a complication of PID, it is not directly caused by untreated gonorrhea. Thus, pelvic inflammatory disease is the