Maternal and Neonatal Outcomes in Gestational Diabetes Mellitus

Abstract

To describe antenatal maternal complications and neonatal outcomes caused by gestational diabetes mellitus. Materials and Methods: This descriptive observa-tional study was conducted in the Department of Obstetrics and Gynaecology (Obs & Gynae), Baha-wal Victoria Hospital, Bahawalpur, Pakistan, over a the period of one year, from January 1 to December 31, 2003. Fifty pregnant women diagnosed by glu-cose tolerance tests as diabetics were enrolled as study subjects and followed regularly at the Obs & Gynae out-patient department. Blood glucose levels were controlled by diet per se or with insulin and subjects were hospitalized for insulin dose adjust-ment and management of complications. Feotal well being was assessed by ultrasound, kick count and cardiotocography. Time and mode of delivery was decided upon at 36th week of gestation. Intra-partum maternal blood glucose level was monitored and fetal monitoring was done by external cardioto-cography. Results: Out of a total of 1429 women delivered, 50(3.5%) were diagnosed as GDM and studied. Forty-four (88%) patients were above 25 years of age and 38(76%) were multiparous. Thirty-two (64%) subjects required insulin to control GDM. Most fre-quent maternal and feotal complications were poly-hydramnios 9(18%) and macrosomia 18(36%), respec-tively. One out of fifty subjects had a spontaneous miscarriage and one had intrauterine death. Caesar-ean section was done in 29(58%) patients. Total number of babies delivered alive were 48(96%). Conclusion: GDM was diagnosed in 3.5% of preg-nant women. Most of the subjects were above 25 years and multiparous. Most common maternal complication was polyhydramnios and caesarean section was a common mode of delivery. Macro-somia and jaundice were most prominent complica-tions among neonates.