OUTCOME OF DIABETES MELLITUS IN PREGNANCY IN A TERTIARY REFERRAL CENTRE

Dr. Umadevi M, Sudha R

Abstract


BACKGROUND AND OBJECTIVES: Gestational Diabetes Mellitus is defined as Impaired Glucose Tolerance with onset or first recognition during pregnancy. Undiagnosed or inadequately treated GDM can lead to significant maternal and foetal complications. The increasing prevalence of type 2 diabetes in general, and in younger people in particular, has led to an increasing number of affected pregnancies. Thus, the number of pregnant women with diabetes that was undiagnosed before pregnancy is increasing. The objective of the study is to determine the effects of diabetes mellitus on mother and foetus.

METHODS: A prospective-cum-descriptive study was conducted among 100 cases of pregnant women with Diabetes Mellitus at Cheluvamba Hospital, MMC&RI, during a period of 18 months starting from November 2016 till April 2018 who fulfilled the inclusion criteria.

Their socio-demographic characters, maternal and foetal outcomes were recorded and results

were concluded using appropriate statistical analysis.

RESULTS: The mean age (±SD) of 60 cases of GDM was 27.30 ± 4.99 years and 40 cases of

overt diabetes mellitus was 27.83±5.03 years. 63 percent of the cases were diagnosed at first

visit and 13 percent of cases were unmasked in the third trimester.

Among the maternal effects, incidences of UTIs and gestational hypertensive disorders were 17% and 35% respectively. The predominant mode of delivery the study subjects underwent was LSCS (56%).

Among the foetal outcomes, 24 babies had Macrosomia. The number of still-births were higher in cases with overt DM compared to gestational DM (p=0.045). Shoulder dystocias and polyhydramnios were also observed in few cases (5 and 7 cases respectively).

 

INTERPRETATION AND CONCLUSION: Our study has thus provided a useful insight into the maternal and foetal effects of diabetes mellitus during pregnancy. Appropriate diagnosis and management of GDM can improve maternal and perinatal outcome. DIPSI guidelines for screening the subjects are both economical and feasible for evaluation of diabetes mellitus in pregnancy.


Keywords


Gestational Diabetes Mellitus; Pre-Gestational Diabet; Overt Diabetes Mellitus.

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References


F.Gary Cunningham and et al WILLIAMS OBSTETRICS 24thEDITION.Pg- 112

Seshiah V, Balaji V, Balaji MS et al. GESTATIONAL DIABETES MELLITUS IN INDIA. J ASSOC PHYSICIANS INDIA 2004;52:707-11.

Sanders LJ. From Thebes to Toronto and the 21st Century: an incredible journey. Diabetes Spectrum 2002;15:56-60

A Practical Guide to Obstetrics- Cost-effective, evidence-based, safe care pg 102-122.

Priyanka Kalra, Chetan Prakash Kachhwaha, and Hilda Victoria Singh.Prevalence of gestational diabetes mellitus and its outcome in western Rajasthan. PMCID: PMC3743369. J Assoc Physicians India. 2011 Apr;59:22730.

Seshiah V, Balaji V, Balaji MS. Prevalence of gestational diabetes mellitus in south India (Tamil Nadu) – a community based study. J Assoc Physicians India. 2008;56:329–33. [PubMed]

Das V, Kamra S, Mishra A. Screening for gestational diabetes and maternal and fetal outcome. J Obstet Gynaecol India. 2004;54:449–51.

Gómez HL, Martínez ML, Rodríguez ZM. Clinical and epidemiological profile of diabetes mellitus in pregnancy, Isle of youth, 2008. MEDICC Rev. 2011;13:29–34. [PubMed]

Hong JU, Rumbold AR, Wilson KJ, Crowther CA. Borderline gestational diabetes mellitus and pregnancy outcomes. BMC Pregnancy Childbirth. 2008;8:31. [PMC free article] [PubMed]

Wahi P, Dogra V, Jandial K, Bhagat R, Gupta R, Gupta S, et al. Prevalence of gestational diabetes mellitus and its outcomes in Jammu region. J Assoc Physicians India. 2011;59:227–30. [PubMed]

Gajjar F, Maitra K. Intrapartum and perinatal outcomes in women with gestational diabetes and mild gestational hyperglycemia. J Obstet Gynaecol India. 2005;55:135–7.

Odar E, Wandabwa J, Kiondo P. Maternal and fetal outcome of gestational diabetes mellitus in Mulago hospital, Uganda. Afr Health Sci. 2004;4:9–14. [PMC free article] [PubMed]

Galindo A, Burguillo AG, Azriel S, et al: Outcome of fetuses in women with

pregestational diabetes mellitus. J Perinat Med 34(4):323, 2006


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