To Study the Clinical Profile, Management and Outcome of Diabetic Pregnancies in a Rural Tertiary Care Institute of Jharkhand
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 1
Abstract
Introduction: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of any severity identified for the first time during pregnancy. Though this definition uniformly detected and classified GDM, its limitations have been known for many years. In 2008-2009, the International Association of Diabetes and Pregnancy Study Groups (IADPSG), an international consensus group with representatives from multiple obstetrical and diabetes organizations, including the American Diabetes Association (ADA), recommended that high-risk women found to have diabetes at their initial prenatal visit, using standard criteria, receive a diagnosis of overt, and not gestational diabetes. Materials and Methods: In this retrospective clinic-based study, clinical case records of 800 pregnant women seen between the January 2015 to January 2018 at Department of Obstetrics and Gynecology, Rajendra Institute of Medical Sciences, Ranchi, were extracted from the Diabetes Electronic Medical Records (DEMR). The DEMR database at DMDSC connects data of different departs of DMDSC in different areas in India and has been used as an effective tool to improve diabetes care and research. Results: The mean maternal age of the women was 29 ± 4 years and mean age of gestation at first visit were 24 ± 8.4 weeks. Seventy percent of the women had a family history of diabetes. Seventy-eight percent of the women delivered full-term babies and 65% underwent a cesarean section. The average weight gain during pregnancy was 10.0 ± 4.2 kg. Macrosomia was present in 17.9% of the babies, hypoglycemia in 10.4%, congenital anomalies in 4.3%, and the neonatal mortality rate was 1.9%. Mean follow-up duration of the 174 women of whom outcome data was available was 4.5 years. Out of the 174, 101 women who were followed-up developed diabetes, of whom half developed diabetes within 5 years and over 90%, within 10 years of the delivery. Conclusion: Diabetes during pregnancy is associated with higher maternal and fetal morbidity. Therefore, early screening, detection, close monitoring, and intervention is essential to reduce maternal and fetal shortand long-term adverse effects, especially in high-risk groups. Pregnancy provides an opportunity to the clinician to control the disease process and inculcate healthy lifestyle practices in these patients.
Authors and Affiliations
Dr. Jasinta Minz, Dr. Karmela Kujur
Keywords
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- EP ID EP430940
- DOI 10.9790/0853-1801026771.
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