This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
Which is best method to assess fetal damage in a diabetes mother in 1st trimester is: 
Select and explain. 
A. Blood sugar estimation, B. Urine ketone assay, C. Amniocentesis to see level of sugar in amniotic fluid, D. Glycosylated Hb
D: Glycosylated Hb
Answer: D: Glycosylated Hb 
Explanation: In diabetic patients:

Most sensitive test/best test to assess the risk of fetal malformation is maternal HbA1 c levels
The best test to detect fetal malformations is USG.

Now question says - which is the most sensitive screening test to detect congenital malformations. Undoubtedly ultrasound should be the first choice but it is not given in the options.