Risk based screening for gestational diabetes mellitus and its fetomaternal outcome

Abstract

Objectives: The objective of this study is to determine the frequency of factors leading to gestational diabetes mellitus and fetomaternal outcomes. Setting: Department of Obstetrics and Gynaecology Unit-II at Liaquat University Hospital Hyderabad. Study Design:  Cross sectional study. Duration of Study: Six months (1st July 2017 to 31st December 2017). Subject and Methods: A total of 86 Women with GDM included in the study by identification of risk factors from history an examination. A sample of capillary blood was tested with glucometer for random blood sugar level. GDM was diagnosed 2 hours blood glucose more than 126 mg/dl.Women with GDM was evaluated and followed to see the maternal outcome i.e. preterm delivery, pre-eclampsia and operative delivery and fetal outcome i.e. congenital anomalies, live birth, still birth, early neonatal death and macrosomia. All the data was entered on a pre-designed proforma attached at the end of synopsis. Results: The average age of the women was 26.23±4.03 years.  Frequency of factors leading to gestational diabetes mellitus was previous history of previous GDM; 66.3%, Previous history of macrosomia54.7%, Polyhydramnios in current pregnancy 51.2%, macrosomia in current pregnancy 44.2%,  previous history of shoulder dystosia 41.9%, and women with BMI >25kg/m2was observed in 32.6% cases. GDM causes significant maternal and fetal complications including preeclampsia 51.2%, preterm 23.3%, and operative delivery 29.1% as well as fetal death was observed in 21(24.4%) in which 17.44% still birth (15/86) and 6.98 (6/86) were neonatal death. Conclusion: Gestational Diabetes Mellitus is associated with increased morbidity in mothers and fetus. Early detection and intervention is important because it improves pregnancy outcome.