Beruflich Dokumente
Kultur Dokumente
2 : March/April 2005
ORIGINAL ARTICLE
Pg 135-137
The Journal of
Obstetrics and Gynecology
of India
OBJECTIVE(S) : To evaluate O Sullivans screening test to identify women at risk for gestational diabetes, evaluate
intrapartum and neonatal outcomes, and analyze the risk factors.
METHODS(S) : Three hundred and seventy eight pregnant women attending the antenatal clinic with gestation of 24 to 28
weeks were recruited for the study. They were given 50g glucose orally, regardless of the time of previous meal, and
one hour later blood was collected for glucose estimation. Women with a plasma glucose level > 140 mg/dL were
subjected to a 75 g 2-hour oral glucose tolerance test.
RESULTS :The detection rate of mild gestational hyperglycemia (MGH) was 6.8% and that of gestational diabetes mellitus
(GDM) was 2.6%. Pregnancy induced hypertention and placental abruption were significantly associated with MGH/
GDM. No statistical association was found with mode of delivery and other intrapartum complications. Babies born to
women with MGH or GDM were eight times more likely to have hypoglycemia and three times more likely to have
jaundice requiring phototherapy , as compared to babies born to women without MGH or GDM.
CONCLUSION(S) : Antepartum, intrapartum and perinatal morbidity is increased in women with both MGH and GDM.
These results need to be validated against a larger cohort.
Key words : gestational diabetes mellitus, mild gestational hyperglycemia, delivery outcome, perinatal outcome
Introduction
Gestational diabetes mellitus (GDM) is defined as any degree
of glucose intolerance with onset or first recognition during
the current pregnancy 1. The definition applies regardless of
whether insulin or diet modification is used for treatment
and whether or not the condition persists after pregnancy. It
does not recognize the possibility that unrecognized glucose
intolerance may have antedated or begun concomitantly with
pregnancy.
135
Gajjar F et al
Compliations
Normal
Mild
Gestational P value
gestional diabeties
hyperglycemia
(n=342)
(n=26)
(n=10)
No. (%)
No. (%)
No. (%)
Pregnancy induced
hypertention
13 (0.29)
5 (19.23)
6 (60.0)
< 0.0001
Abruptio placentae
10 (2.92)
9 (34.61)
2 (20.0)
< 0.0001
Preterm delivery
18 (5.26)
3 (11.53)
0.70
Intrauterine growth
restriction
16 (4.67)
1 (3.85)
1 (10.0)
0.86
1 (10.0)
0.67
8 (30.76)
0.00
None
Fasting value
105 mg / dL.
136
283 (82.74)
Four women each in the GDM and MGH group had both abruption and
PIH.
6 (2.35)
Apgar < 7
at 1 min
3 (8.33)
18 (7.05)
Hypoglycemia
2 (5.55)
Hypocalcemia
1 (0.39)
Outcome
Jaundice requiring
phototherapy
GDM / MGH
(n=36)
No (%)
Normal
(n=251)
No (%)
Relative Risk
P
with 95% CI value
Birth weight
> 3.5 kg
7 (19.44)
Spontaneous
vaginal delivery
Instrumental
vaginal delivery
4 (11.11)
Shoulder dystocia
1 (0.39)
0.25
Postpartum
hemorrhage
2 (0.79)
0.59
Meconium
5 (13.89)
25 (9.96)
Malpresentation
1 (2.77)
12 (4.78)
0.25
4 (11.11)
5 (1.96)
2 (0.78)
0.58
9 (3.53)
0.79
Congenial anomaly
Cesarean delivery
Acknowledgements
The authors thank Dr. V. Mazumdar, Department of
Community Medicine, Medical College Baroda, for his help
with the statistical analysis and Dr. Rakesh Shah, pathologist
for laboratory assistance.
References
1.
2.
3.
4.
Coustan DR, Widness JA, Carpenter MW et al. Should the fifty gram
one-hour plasma glucose screening test for gestational diabetes be
administered in the fasting or fed state ? Am J Obstet Gynecol
1986;154:1031-5.
5.
6.
7.
8.
9.
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