A study of feto-maternal outcome in cases of gestational diabetes mellitus
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20230039Keywords:
Gestational diabetes mellitus, Demographic parameters, Glycemic control, Maternal and fetal complications associated with gestational diabetes mellitusAbstract
Background: The aim of the study was to determine prevalence of gestational diabetes mellitus in the community, demographic parameters like age at diagnosis, parity, complications related to gestational diabetes mellitus, and plan the management of gestational diabetes mellitus and to reduce the maternal and perinatal morbidity and mortality. The objective of this study was to evaluate the risk factors and fetomaternal outcome in mothers with gestational diabetes mellitus.
Methods: In this prospective cross sectional study we included 120 patients with gestational diabetes mellitus were studied for fetomaternal outcome. The study was conducted from January 2021 to June 2022 at department of obstetrics and gynecology, B. J. Medical College and Civil Hospital, Ahmedabad.
Results: Total 120 cases of gestational diabetes mellitus were studied. It was observed that gestational diabetes mellitus were more common in elderly age group (54.16%), multigravida patients were most commonly involved (48.33%). Past history of gestational diabetes mellitus was present in 39.81% of cases, 68.34% of cases required insulin for glycemic control, 63.34% cases required delivery by Caesarean section, maternal complications like preeclampsia (20 cases), polyhydroamnious (44), uteroplacental insufficiency (10), macrosomia, sudden IUFD (7) and operative delivery were common outcome. 12 neonates developed respiratory distress syndrome, 17 developed hypoglycemia and 26 neonates required NICU admission, 12 neonates underwent perinatal mortality.
Conclusions: Gestational diabetes mellitus has become a global public health burden. Early detection of gestational diabetes mellitus, timely referral, frequent antenatal visits, and management of the identified cases at tertiary care centers can lead to decreased maternal and feral morbidity and mortality.
References
American Diabetes Association. Standards of medical care in diabetes--2010. Diabetes Care. 2010;33(1):S11-61.
International Association of Diabetes and Pregnancy Study Groups Consensus Panel; Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676-82.
Rowaily MA, Abolfotouh MA. Predictors of gestational diabetes mellitus in a high-parity community in Saudi Arabia. East Mediterr Health J. 2010;16(6):636-41.
Thomas B. The prevelance, risk factors, maternal and fetal outcomes in in gestational diabetes mellitus. Int J Drug Develop Res. 2012; 4(3):356-68.
Jindal A. Prevalence, clinical profile and outcome of gestational diabetes mellitus. J Obstet Gynaecol. 2001;51:46-8.
Saxena P, Tyagi S, Prakash A, Nigam A, Trivedi SS. Pregnancy outcome of women with gestational diabetes in a tertiary level hospital of north India. Indian J Community Med. 2011;36(2):120-3.
Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373(9677):1773-9.
Williams JW, Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS. Williams obstetrics. 25th ed. New York: McGrowHill; 2018: 1107.
Tuffnell DJ, West J, Walkinshaw SA. Treatments for gestational diabetes and impaired glucose tolerance in pregnancy. Cochrane Database Syst Rev. 2003;(3):CD003395.
NICE. NICE 2020 guidelines Diabetes in pregnancy: management from preconception to the postnatal period, 2020. Available at: www.nice.org.uk/ guidance/ NG3. Accessed on 22 December 2022.
O'sullivan JB, Mahan CM. Criteria for the oral glucose tolerance test in pregnancy. Diabetes. 1964;13:278-85.
