A prospective study on the maternal and perinatal outcome in gestational <em>Diabetes mellitus</em>

Abstract

xxBackground and Objective: Gestational Diabetes mellitus (GDM) is the most prevalent among Asian population. There are specific risks and complications of uncontrolled diabetes in pregnancy affecting both mother and fetus. Gestational Diabetes mellitus has increased risk of Type 2 Diabetes mellitus and obesity in off springs. The main objective of the present study was to determine the maternal and fetal outcome in Gestational Diabetes Mellitus subjects studied during pregnancy. Materials and Methods: A total of 130 (n=130) antenatal cases with diagnosed Gestational Diabetes Mellitus condition registered at Department of Obstetrics and Gynaecology, Maharajah’s Institute of Medical Sciences Hospital, Nellimarla, Vizianagaram Dist., Andhra Pradesh, were selected for the present study. The study subjects were selected after screening for GDM by using single step Oral Glucose Challenge Test (OGCT) procedure according to recent DIPSI guidelines, between 24-28 weeks of gestation, on outpatient department (OPD) basis. The cut-off value for OGCT was 140 mg/dL. All the patients were followed up, treated for GDM with diet / OHA / insulin therapy till delivery and maternal and perinatal outcome was observed in all the subjects. Results: In this study, obesity, family history of DM was more common risk factors in GDM population as compared to normal population. 47.69% patients belonged to age group between 26 to 30 years. 53.8% subjects had history of fetal loss prior to this pregnancy like abortion, still birth, intra uterine death (IUD). The outcome of subjects with GDM showed 66.9% subjects underwent Lower Segment Caesarean Section (LSCS), 33.1% subjects had preterm delivery and 1.5% had intra uterine death. 8.5% neonates born to GDM mothers had Neonatal Intensive Care Unit (NICU) admission. Conclusion: In the present study GDM incidence was more in the age group between 26-30 years. More than 50% of subjects had history of fetal loss. Obesity, family history of diabetes mellitus and preeclampsia history had statistically significant risk factors in GDM patients. More than 2/3rd of patients underwent LSCS. Perinatal complications like prematurity, NICU admission, IUFD was seen.