A Study on Maternal and Perinatal Outcome in Gestational Diabetes Mellitus
Muhammad Qasim, Abroo Bahadur, Kashif Ali Samin, Bushra Bashir, Maaz Zafar, Adnan Rahman
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ABSTRACT
Background and Aim: Gestational
diabetes is initially diagnosed as glucose intolerance in pregnancy which might
result in adverse maternal and perinatal outcomes. The present study aimed at different
maternal and perinatal outcomes associated with pregnancy complicated by
gestational diabetes.
Methodology: This cross-sectional
study was carried out on 148 women diagnosed with gestational diabetes in the department
of Diabetes and Endocrinoogy and Obstetrics/ Gynecology, Hayatabad Medical Complex, Peshawar and Mian
Rashid Hussain Shaheed Memorial Hospital Pabbi respectively for duration of six
months from April 2021 to September 2021. Maternal and perinatal data
were taken from patients' medical records in the hospital database. The data
included age, gestational age, parity, mode of delivery, BMI, infant birth weight,
antenatal complications and both maternal and neonatal morbidity and mortality.
All the women with multiple pregnancies and who presented with the breech in
the labor room were excluded. Estimation of platelet count and renal function
test were performed in order to evaluate the maternal and fetal outcomes in
addition to estimation of blood glucose levels and routine investigations.
Results: Of the total 148 diagnosed with gestational diabetes, the majority of
women 97 (65.5%) had an age between 20 and 30 years followed by 30 to 40 years
42 (28.4%). A higher incidence of pregnancy induced hypertension 18 (12.2%),
cesarean section 87 (58.8%), labor induction 58 (39.2%), macrosomia in 4
(2.7%), and preterm delivery in 5 (3.4%) was reported despite early diagnosis
and treatment of gestational diabetes. The prevalence of perinatal morbidity
was 43 (29.1%) whereas the mortality was 5 (3.4%). Neonatal hypoglycemia in 49
(33.1%), meconium aspiration syndrome 12 (8.1%), hyperbilirubinemia 19 (12.8%),
and requirement of neonatal unit admission 37 (25%) were common causes of
perinatal morbidity. Neonatal and intrauterine deaths were reported in 3 (2%)
and 2 (1.4%) respectively.
Conclusion: The prevalence of
maternal and perinatal morbidity and mortality increased in women with
gestational diabetes. A 75 g oral glucose tolerance test was used for screening
of gestational diabetes in pregnant women during 24 to 28 weeks gestation which
assisted in earlier diagnosis and timely intervention, in turn, reducing
complications. Pregnancy outcomes might be improved with the proper management
of gestational diabetes.
Keywords: Maternal outcome, Perinatal outcomes, Gestational
diabetes