Fetomaternal Outcome in Gestational Diabetes Mellitus at a Tertiary Care Hospital
Introduction: Gestational diabetes mellitus (GDM) is a common medical problem that results from an increased severity of insulin resistance as well as impairment of the compensatory increase in insulin secretion. GDM has profound effects on fetomaternal outcome.
Aims and Objectives: This study aims to evaluate the impact of GDM on pregnancy and fetal outcome.
Materials and Methods: The present study was a prospective observational study. The screening was done by glucose challenge test and 3 h, 100 g glucose tolerance test. The study population was divided into two groups, cases and controls. All the patients were followed up for maternal complications, fetal complications, mode of delivery, and neonatal complications.
Results: A total of 350 randomly selected pregnant females who met the inclusion criteria were subjected to oral glucose challenge test. Of 350 women, 22 women were found to have GDM and were compared with non-GDM patients. GDM patients had significantly higher percentage of pregnancy-induced hypertension (13.6% vs. 2.6%, P = 0.031), polyhydramnios (22.7% vs. 4.3%, P = 0.004), urinary tract infection (40.9% vs. 14.5%, P = 0.003), and excess weight gain (36.4% vs. 6.3%, P = 0.001). GDM patients had higher cesarean deliveries in 13 (59.1%) and assisted vaginal deliveries in 2 (9.1%) as compared to non-GDM (110 [36.3%] and 6 [2%], P = 0.006, respectively). Among the fetal outcome, GDM patients had higher macrosomia (31.8% vs. 8.3% in non-GDM group [P = 0.003]), neonatal convulsions (18.2% vs. 2.3% in non-GDM group [P = 0.003]), respiratory distress (22.7% vs. 3.3% [P = 0.002]), and neonatal intensive care unit admission (72.7% vs. 12.9% [P = 0.001]).
Conclusion: GDM is associated with both maternal and fetal complications, most notably macrosomia leading to increased cesarean section rate and instrumental deliveries
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