Background and aims:We surveyed late preterm and term mother-newborn dyads (n=380) in a tertiary care hospital to determine the epidemiology of breastfeeding problems during initial 72 hours.
The present study was a retrospective study, carried out by total of 100 cases in the Obstetric And Gynaecology department of a secondary care hospital, Tiruppur, Tamil Nadu. There were 100 pregnant women who had gestational diabetes. Increasing gravida (secondary gravida G2 -44% ) shows more prevalence of GDM than primi (34%).Body Mass Index , family history of diabetes and previous history of GDM shows more significance in occurring GDM. Among 100 population, 45% patients receiving insulin with medical nutritional therapy (MNT) ,30% patients receiving medical nutritional therapy (MNT) alone , 11% patients receiving medical nutritional therapy (MNT) with metformin, 3% patients receiving medical nutritional therapy (MNT) with Oral Hypoglycaemic Agents (OHA) and insulin , 3% patients receiving insulin alone and 8% patients didn’t receiving any therapy. Overall 96% of women with GDM had one or more complications and 4% had no complication. From this , 35.89% patients shows caesarean delivery with recurrent GDM, followed by 10.25% patients shows caesarean delivery with polyhydramnios, 15.38% patients shows caesarean delivery with Pregnancy Induced Hypertension (PIH).Overall 74% of new-borns had one or more complications and 27% had no complication. 24.32% patients shows macrosomia with neonatal hypoglycaemia, 16.21% patients shows macrosomia with preterm birth, 13.52% patients shows macrosomia with hyperbilirubinemia. Our study concludes that the complications arise from GDM to both mother and new-borns can be resolved and minimised by proper diagnosis and appropriate treatment during the pregnancy.
Keywords: Gestational Diabetes Mellitus, Drug Utilization Pattern, Complications, Oral Glucose Tolerence Test
Gestational Diabetes Mellitus [GDM] is defined as the carbohydrate intolerance during pregnancy.In GDM glucose intolerance can be notified due to fetal development and other contributing factors, this may response to severe condition of hyperglycemia in pregnancy. Various maternal and prenatal adverse outcomes may resulted by GDM. The prevalence of GDM have a steep increase by year to year by the influence of contributing factors such as advancing age, life style modifications, changed diet pattern etc. The overall prevalence of GDM noted as 1-14% among population, also the epidemiological studies states that the occurrence of GDM varies on the basis of ethnic and racial composition. The pathophysiology of gestational diabetes is assumed by various factors but exact cause of is unknown. Gestational diabetes is influenced by hormones produced by placenta, progesterone, estrogen, human placental lactogen [HPL], human chronic somatotropin [HCS] etc. Women with Polycystic Ovarian Syndrome [PCOS] and family history of Type 2 diabetes mellitus are at high risk of having GDM. GDM on pregnancy period causes some important complications such as high cesarean sections, preeclampsia, post partum type 2 diabetes mellitus, urinary tract infection in both neonate and the mother, cardiovascular disease, hypertension and stroke in mother, also neonatal consequences such as congenital malformations, macrosomia, adiposity, hypoglycaemia, birth injuries and prenatal death. This overview describes all the complications of pregnant women and newborns due to GDM with the conclusion of treatment profile.
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