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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 10, Issue 2, March 2014 pp 323-330
Gestational Diabetes Mellitus Diagnosed with 2hr 75g- Oral Glucose Tolerance Test (D.I.P.S.I) and Its Adverse Perinatal Outcome
Sanjaykumar Patil1, Pallavi D. Pandey2, R. P. Patange3
1Assistant Professor, 2Resident, 3Professor
Department of OBGY, Krishna Institute of Medical Sciences, Karad, Satara , Maharashtra, INDIA.
Academic Editor : Dr. Aher K. R.
Objective: The aim of the study was to assess the maternal and fetal complications of pregnancy in mothers with gestational diabetes mellitus compared with non-diabetic mothers. Method: A Prospective cohort study of 1000 consecutive non- selected pregnancies who came to Krishna Hospital for routine antenatal screening in the year 2011-2013. Diagnosis of Gestational diabetes mellitus was done by single step screening -75gms glucose OGTT(ORAL GLUCOSE TOLERANCE TEST) suggested by D.I.P.S.I. The outcome of pregnancy in 220 patients (22%) with gestational diabetes identified and matched for age, parity, body mass index with 220 non-diabetic controls were studied retrospectively from case files. Results: The G.D.M patients were treated with either diet alone (M.N.T) or with additional insulin in some patients who required for better control of their blood sugar levels. Patients with G.D.M had a significantly higher incidence of pre-eclampsia( 38% p<0.001); preterm delivery (18% p=0.0226); induction of labour(15% p<0.001); caesarean section (60% p =0.003);higher mean birth weight of babies( 3.335+/-0.5 p<0.001); macrosomia (30% p=0.0186) and admission to the neonatal intensive care unit (16% p=0.003) compared with the control group. The rates of apgar score <7 at 5 mins, respiratory distress syndrome, neonatal hypoglycemia, hyperbilirubinemia and the need for phototherapy were higher in G.D.M patients. Congenital anomaly and perinatal mortality rates were not significantly different in the two groups. Women with early diagnosis of gestational diabetes mellitus had a significantly increased need for insulin treatment during pregnancy (36% versus 9% p<0.005) and a significantly higher occurrence of diabetes mellitus at follow up from two months. Conclusions: G.D.M is recognised to be associated with increased rates of adverse maternal and neonatal outcomes which are supported by the findings of this study. Even the mild forms of G.D.M. seem to have significant consequences for women and their offspring’s and it’s recommended to treat them aggressively. Evidence suggests early diagnosis and strict control of blood sugar level throughout the pregnancy can significantly reduce maternal and fetal complications.