Publication:

Survey of obstetric and neonatal outcome in gestational diabetes mellitus

Background India being the diabetic capital of the world, Indian women have a high prevalence of gestational diabetes mellitus (16.5%). It can cause a wide range of complications as well as long term implications in both the mother and fetus. A large proportion of women also progress to become overt diabetics in the future hampering with their quality of life by causing morbidity in various forms. Aim of this study is to evaluate the fetomaternal outcome in women with gestational diabetes mellitus at a tertiary care teaching hospital and the incidence of glucose intolerance in these women during the postpartum period.

Methods All patients attending the antenatal OPD were offered a 75g glucose challenge test and 200 patients diagnosed with GDM were included in the study for a period of one year. Fetomaternal complications were studied and postpartum follow up was done in these patients.

Results Out of these 200 women, 49% delivered via LSCS, 46% via labor naturalis and 5% via instrumental delivery. 59.5% were on insulin and 40.5% were treated with meal plan. Pre-eclampsia complicating pregnancy was seen in 26%, polyhydramnios was encountered in 17.5%, Urinary tract infection in 11%, preterm labour in 8.5% and PROM in 7%. Adverse fetal outcome was seen in 5% of the babies. Birth asphyxia was seen in 7.5%, macrosomia in 13%, 5% of the babies had congenital anomalies. In the postapartum follow up at 6 weeks 22.5% of the study population were glucose intolerant (75 gm OGTT).

Conclusions Early detection and prompt management of this condition can tremendously reduce the short term and long-term complications in both the mother and fetus.