Analysis of maternal and fetal outcome in gestational diabetes mellitus
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20243953Keywords:
Gestational diabetes mellitus, OGTT 75 gm, Glycosylated hemoglobinAbstract
Background: Diabetes is the most common medical complication of pregnancy. Glycemic control throughout pregnancy and a late-pregnancy HbA1c level <6.5 percent leads to reduced rates of adverse obstetrical and neonatal outcomes.
Methods: A retrospective observational study was conducted in the Department of Obstetrics and Gynaecology, Shri Lal Bahadur Shastri medical college Mandi, Himachal Pradesh for a period of one and half years from 1st January 2023 to 30th June 2024. All the pregnant women with gestational diabetes mellitus were included in the study.
Results: The prevalence of gestational diabetes mellitus was 128 (2.02%). The most common age group was 26-30 years. There were 7.8% obese and 90.6% over weight patients. Most of the patients (54.68%) were treated by medical nutrition therapy (MNT) followed by insulin (34.3%). The most common maternal complication was hypertension (15.6%) and 31.25% babies had admission in neonatal care unit. 10 (7.8%) babies had birth asphyxia and neonatal death.
Conclusions: Single step screening with 75 gm OGTT is being followed in our state and the universal screening has improved the maternal and neonatal outcomes with GDM. Enhanced screening, timely intervention and motivation of the GDM patients on diet control, metformin or insulin to achieve euglycaemia can reduce maternal, fetal and neonatal complications.
Metrics
References
Cunningham F, Leveno K, Bloom S, Hauth J,Gilstrap L, Rouse D et al. Fetal growth disorders.Williams Obstetrics. 26thedition. New York, McGraw Hill Professionals; 2022:2116-56.
Mishra R,Ian Donald,s Practical Obstetric Problems,Diabetes 6th ed. 2007;129-130.
Powers AC, Niswender KD, Evans-Molina C. Diabetes mellitus: diagnosis, classifications, and pathophysiology. In Jameson JL, Fauci AS, Kasper DL, et al (eds): Harrison’s Principles of Internal Medicine, 20th ed. New York, McGraw Hill Education, 2018.
Baschat AA, Galan Henry L. Intrauterine growth restriction. Gabbe,s Obstetrics Essentials: Normal and Problem Pregnancies.7th ed Elsevier.2019:563-80.
Finneran MM, Kiefer MK, Ware CA. The use of longitudinal hemoglobin A1c values to predict adverse obstetric and neonatal outcomes in pregnancies complicated by pregestational diabetes. Am J Obstet Gynecol. 2020;2(1):100069.
International Diabetes Federation. Idf diabetes atlas. 2013. 2019. Available at: https://diabetesatlas.org/. Accessed on 05 May 2024.
Poovathi M, Gayathri Devi S. A prospective study on gestational diabetes mellitus in a tertiary care center. Int J Reprod Contracept Obstet Gynecol. 2018;7(12):4972-6.
Dharmavijaya MN. Analysis of gestational diabetes mellitus from a tertiary care hospital. Indian Journal of Obstetrics and Gynecology Research. 2017;4(1):17-20.
Seshiah V, Balaji V, Balaji MS, Sanjeevi CB, Green A. Gestational Diabetes Mellitus in India. J Assoc Physicians India. 2004;52:707-11.
Zargar AH, Sheikh MI, Bashir MI, Masoodi SR, Laway BA, Wani AI, et al. Prevalence of gestational diabetes mellitus in Kashmiri women from the Indian subcontinent. Diab Res Clinic Prac. 2004;66(2):139-45.
Ganguly A. A Study of Diabetes Mellitus over 8 years. J Obstet Gynecol India.1995;45:27-31.
Dashe JS, Nathan L, McIntire DD. Correlation between amniotic fluid glucose concentration and amniotic fluid volume in pregnancy complicated by diabetes. Am J Obstet Gynecol. 2000;182:901.
Gunjan. Examination of gestational diabetes mellitus at a tertiary care hospital Int J Res Med Sci. 2024;12(9):3279-83.
Johnston RC, Gabby L, Tith T. Immediate postpartum glycemic control and risk of surgical site infection. J Matern Fetal Neonatal Med. 2017;30(3):267.
Jovanovič L, Liang Y, Weng W. Trends in the incidence of diabetes, its clinical sequelae, and associated costs in pregnancy. Diabetes Metab Res Rev. 2015;31(7):707.
Downloads
Published
How to Cite
Issue
Section
