An Observational Study of Gestational Diabetes Mellitus in Women with Bad Obstetric History at A Tertiary Care Centre
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- 1. International Journal of Medical Science and Innovative Research (IJMSIR)
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Abstract
Background: Gestational Diabetes Mellitus (GDM) is a common pregnancy complication that poses significant risks to both maternal and fetal health. Women with a history of Bad Obstetric History (BOH), defined by recurrent pregnancy losses, preterm deliveries, stillbirths, or previous macrosomic babies, are at an elevated risk of GDM and its associated complications. The present study was undertaken to estimate the prevalence of Gestational Diabetes Mellitus (GDM) in women with Bad Obstetric History (BOH) and to study maternal and fetal outcome after controlling blood sugars to provide insights into better management strategies for these high-risk pregnancies.
Methods: In this prospective observational study, 52 pregnant women with BOH and GDM were studied in the Department of Obstetrics and Gynecology, at Lokmanya Tilak Municipal Medical College and Hospital, Mumbai during the period of 18 months from January 2020 to June 2021.
Result: The prevalence of Gestational diabetes mellitus (GDM) in women with Bad Obstetric History was 24.18%. The average maternal age at the time of diagnosis was 25.70 ± 06.57 years. The average duration of pregnancy at diagnosis of GDM was 29±4.33weeks. Mean Gestational Age at delivery with SD 37.39 ±1.64. The mean gravidity was 4±0.82. All were multigravidas in this study and had an average body mass index (BMI) of 25.22 ±2.33. The mean blood glucose values were mg/dl at diagnosis. Twenty-two (22) patients (42.30%) were treated with metformin and subcutaneous insulin. Twenty-one (21) patients (40.38%) were treated with Metformin. Eighty women (58%) received subcutaneous insulin, and 9 patients (17.30%) were managed with dietary advice alone. Most common mode of delivery was LSCS- 23 cases (44.24%). Maternal complications observed were polyhydramnios in 17 cases, PROM in 10 cases, preterm delivery in 7 cases, and shoulder dystocia in 3 cases. There were 49 live births and 3 fetal deaths. Thus, maximum patients had good outcome.
Conclusion: Hence, treatment of gestational diabetes mellitus (GDM) can improve pregnancy outcome in cases of bad Obstetric history.
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References
- 1. American Diabetes Association. Classification and diagnosis of diabetes: Standards of medical care in diabetes—2020. Diabetes Care. 2020; 43(Suppl 1): S14–31. 2. Bellamy L, Casas JP, Hingorani AD, Williams D. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007; 335(7627):974. 3. Singh G, Sidhu K. Bad obstetric history: A prospective study. Med J Armed Forces India. 2010; 66(2):117–20. 4. Rasmussen KM, Yaktine AL. The implications of gestational diabetes for the child: The role of maternal hyperglycemia. Pediatr Diabetes. 2017; 18(5):309–15. 5. Catalano PM, Tyzbir ED, Roman NM. Gestational diabetes and the development of type 2 diabetes mellitus: Evidence for a role of insulin resistance. Diabetologia. 2012; 55(10):2694–702. 6. Mantri, N., Goel, A.D., Patel, M. et al. National and regional prevalence of gestational diabetes mellitus in India: a systematic review and Meta-analysis. BMC Public Health 24, 527 (2024). https://doi.org/10.1186/s12889-024-18024-9 7. Todi S, Sagili H, Kamalanathan SK. Comparison of criteria of International Association of Diabetes and Pregnancy Study Groups (IADPSG) with National Institute for health and care excellence (NICE) for diagnosis of gestational diabetes mellitus. In: Arch Gynecol Obstet, vol. 302. Berlin Heidelberg: Springer; 2020. p. 47–52. https:// doi. org/ 10. 1007/ s00404- 020- 05564-9. 8. Bhargavi AWB, SailathaR, Anuradha CR. Changing trends of causative factors in antenatal mothers with bad obstetric history: a retrospective study.Int J Reprod Contracept Obstet Gynecol 2021; 10:3371-4. 9. Rajasekar G, Muliyil DE, Cherian AG, Prasad JH, Mohan VR. Prevalence and factors associated with gestational diabetes mellitus among antenatal women at a rural health center in Vellore. J Assoc Physicians India. 2019 Jun; 67(4):42-7. 10. Gowthami B, Kumari J and Narayanamma V / Indian Journal of Obstetrics and Gynecology Research 2021;8(4):535–540 11. Singh G, Sidhu K. Bad Obstetric History: A Prospective Study. Med J Armed Forces India. 2010 Apr; 66(2):117-20. doi: 10.1016/S0377-1237(10)80121-2. Epub 2011 Jul 21. PMID: 27365723; PMCID: PMC4920907. 12. Gopalakrishnan V, Singh R, Pradeep Y, Kapoor D, Rani AK, Pradhan S, et al. Evaluation of the prevalence of gestational diabetes mellitus in north Indians using the International Association of Diabetes and Pregnancy Study groups (IADPSG) criteria. J Postgrad Med. 2015; 61:155–8. 13. Bhavadharini B, Mahalakshmi MM, Anjana RM, Maheswari K, Uma R, Deepa M, et al. Prevalence of gestational diabetes mellitus in urban and rural Tamil Nadu using IADPSG and WHO 1999 criteria (WINGS 6). Clin Diabetes Endocrinol. 2016:2. https:// doi. org/ 10. 1186/ s40842- 016- 0028-6. 14. Agarwal MM, Punnose J, Sukhija K, Sharma A, Choudhary NK. Gestational diabetes mellitus: using the fasting plasma glucose level to simplify the International Association of Diabetes and Pregnancy Study Groups Diagnostic Algorithm in an adult south Asian population. Can J diabetes. 2018; 42:500–4. https:// doi. org/ 10. 1016/j. jcjd. 2017. 12. 009. 15. Prakash GT, Das AK, Habeebullah S, Bhat V, Shamanna SB. Maternal and neonatal outcome in mothers with gestational diabetes mellitus. Indian journal of endocrinology and metabolism. 2017 Nov; 21(6):854. 16. Ayaz A, Saeed S, Farooq MU, Ali Bahoo ML, Hanif K. Gestational diabetes mellitus diagnosed in different periods of gestation and neonatal outcome. Dicle Medical Journal/Dicle Tip Dergisi. 2009 Dec 1; 36(4). 17. Jain S, Jain V. Maternal and perinatal outcome in gestational diabetes. Insulin; International Journal of Clinical Obstetrics and Gynaecology 2018; 2(3): 06-09. 18. Rajput R, Yadav Y, Nanda S, Rajput M. Prevalence of Gestational Diabetes Mellitus & Associated Risk Factors At A Tertiary Care Hospital in Haryana. The Indian Journal of Medical Research. 2013; 137(4):728-733. 19. Shridevi AS, Prabhudev P, Bhovi MR. A clinical study of prevalence of gestational diabetes mellitus and associated risk factors at a tertiary care centre in Karnataka, India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2015 Nov 1; 4(6):1840-6. 20. Naik RR, Pednekar G, Cacodcar J. Incidence and risk factors of gestational diabetes mellitus in antenatal mothers in Goa, India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2019 Feb 1; 8(2):586-91. 21. Muche AA, Olayemi OO, Gete YK. Effects of gestational diabetes mellitus on risk of adverse maternal outcomes: a prospective cohort study in Northwest Ethiopia. BMC pregnancy and childbirth. 2020 Dec; 20(1):1-3. 22. Chanu MM. June A. Clinical study on fetomaternal outcome in GDM.IOSR Journal.vol14. issue 4(April 2015)53-56. 23. Bhattacharya S, Nagendra L, Krishnamurthy A, Lakhani OJ, Kapoor N, Kalra B, Kalra S. Early Gestational Diabetes Mellitus: Diagnostic Strategies and Clinical Implications. Medical Sciences. 2021 Dec; 9(4):59. 24. Majella MG, Sarveswaran G, Krishnamoorthy Y, Sivaranjini K, Arikrishnan K, Kumar SG. A longitudinal study on high risk pregnancy and its outcome among antenatal women attending rural primary health centre in Puducherry, South India. Journal of education and health promotion. 2019;8. 25. Syeda Birjees Anwar Kazmi, Syed Abid Hassan Naqvi, Zamir Iqbal et al. Maternal and Neonatal Outcomes of Gestational Diabetes Mellitus PJMHS 2012; 6(2):32. 26. Prakash GT, Das AK, Habeebullah S, Bhat V, Shamanna SB. Maternal and neonatal outcome in mothers with gestational diabetes mellitus. Indian J Endocr Metab 2017; 21:854-8. 27. Satyavathi G.A.L., Chitti Sudha A. Study on maternal and foetal outcome of pregnancy with positive glucose tolerance test by diabetes in pregnancy study group diagnostic criteria. Int J Reprod Contracept Obstet Gynecol 2019; 8:3510-7. 28. Kumari R, Dalal V, Kachhawa G, Sahoo I, Khadgawat R, Mahey R, Kulshrestha V, Vanamail P, Sharma JB, Bhatla N, Kriplani A. Maternal and perinatal outcome in gestational diabetes mellitus in a tertiary care hospital in Delhi. Indian journal of endocrinology and metabolism. 2018 Jan; 22(1):116. 29. Deryabina EG, Yakornova GV, Pestryaeva LA, Sandyreva ND. Perinatal outcome in pregnancies complicated with gestational diabetes mellitus and very preterm birth: case–control study. Gynecological Endocrinology. 2016 Sep 30; 32(sup2):52-5.