Background: In recent times, gestational diabetes is becoming more common Worldwide and complications are seen in fetal development, growth, labour and delivery due to maternal hyperglycemia. Gestational Diabetes Mellitus(GDM) is associated with adverse maternal and fetal outcomes. Among South Asian Population, Indian Women are at high risk of developing carbohydrate intolerance during pregnancy. Hence this study is undertaken to screen for gestational diabetes mellitus by two step method in Indian Women.Methods: This study was done in 153 nondiabetic pregnant women of gestational age 24-28 weeks, excluding diabetes mellitus diagnosed prior to pregnancy. Two step method was followed in the present study and GDM was diagnosed and the pregnancy outcomes were noted.Results: In our study the prevalence of GDM is 8.1% by two step method. Most of the women diagnosed with GDM were of age 26-30 yrs (41.66%). Among the women who were diagnosed as GDM, (58.33%) cases required Insulin along with diet control. In our study 33.33% had vaginal delivery, 8.33% had Emergency LSCS and 58.33% had Elective LSCS.Conclusion: Indian Women have high prevalence of GDM, hence universal screening is essential to diagnose GDM, which will improve the pregnancy outcome.
Background: As Indian women has increased risk of developing GDM, screening for GDM is essential for early diagnosis and treatment and hence to reduce the adverse neonatal outcomes. Methods: The antenatal women are screened for GDM by administering 50g GCT and the screening test value of >130mg/dl measured at 1 hours were considered screening test positive and subjected to standard 2 hour 75gm OGTT and the neonatal outcome were observed in relation to neonatal birth weight, Apgar, and the occurrence of complications like hypoglycemia, hypocalcemia, hyperbilirubenemia. Results: The average neonatal birth weight in the study population was 3kg. The women with GDM who required diet alone had average neonatal birth weight of 2.9kgs and the GDM women who were on diet and insulin therapy had average neonatal birth weight of 3.4kg. There was increased incidence of hyperbilirubinemia 33.3% .There was only 1 preterm birth. Conclusions: There is association with neonatal Complications like hyperbilirubenemia and hypoglycemia with women who had screening positive for GDM.
Background: Gestational diabetes mellitus (GDM) is common worldwide. It is a disorder of carbohydrate metabolism. Indian women have increased risk of developing GDM, and leads to adverse Maternal and neonatal outcomes. Women with raised uric acid in pregnancy are interlinked with more incidence of unfavorable outcomes in pregnancy such as GDM. Hence this study is done to prove the utility of uric acid in early diagnosis of GDM by starting early treatment so as to reduce the complications in pregnant women.Methods: The antenatal women are screened for GDM by serum uric acid levels with gestational age <12 weeks. These antenatal women are followed up around 24-28 weeks and oral glucose tolerance test is done and evaluated for GDM using ADA criteria.Results: In our study, serum uric acid cut–off of 4.2 mg/dl had a positive association with the GTT values with p value less than 0.05 (p=0.018). In this study, in the raised serum uric acid category, 8 (19%) were positive for GTT and among the normal serum uric acid category, 3 (4.7%) were positive for GTT. Thus, we observe from our study that elevated levels of uric acid during the first trimester is interlinked with prediction of gestational diabetes.Conclusions: The diagnosis of serum uric acid level in first trimester as a predictor of GDM is easy and economical and it can be used as a screening test for prediction of GDM.
Background: Abnormal uterine bleeding (AUB) is the most common complaint worldwide. In India, most of the women present with menorrhagia and majority of them are anemic and require medical management to avoid its consequences. Hence this study is done to compare the efficacy of ormeloxifene with norethisterone in women presenting with AUB.Methods: In this study 61 women suffering from AUB were included. This prospective randomized double blinded study was done on women between the age group of 19-45 years and were allocated randomly into two groups, one group was given ormeloxifene and the other was given norethisterone for a period of 3 months. Haemoglobin levels, endometrial morphology on ultrasound were assessed before and after the treatment in both the groups.Results: It is observed in our study, that both ormeloxifene and norethisterone reduced menorrhagia. The rise in hemoglobin concentration was significantly more with ormeloxifene than norethisterone (8.3 g/dl to 10.3 g/dl versus 9.0 g/dl to 10.4 g/dl). In our study, the significant reduction in the endometrial morphology was more with ormeloxifene than norethisterone (9.3 mm to 7.8 mm versus 8.3 mm to 7.2 mm).Conclusions: Ormeloxifene is a new modality drug and is found to be a better option in reducing menorrhagia compared with norethisterone in respect to a greater success rate, better compliance and cost effectiveness. Hence our study concludes ormeloxifene as a better choice over norethisterone in the treatment of AUB.
Background: Abnormal uterine bleeding (AUB) is the most common complaint worldwide. Among Indian women, AUB not only affects the quality of life but also leads to serious consequences such as anemia. prolonged and frequent periods lead to morbidity, diminished quality of life and social embarrassment. Hence this study is undertaken to correlate the endometrial morphology by transvaginal ultrasound with histopathological findings of endometrium in women with AUB.Methods: In this study 173 women suffering from AUB were included. This cross-sectional study was conducted by Transvaginal ultrasound using a 7.5 Mhz Philips Transvaginal sonography (TVS) probe to study endometrial morphology (ET). It is measured at the thickest part in the longitudinal plane and included both endometrial layers. Endometrial sampling and histopathological examination were done.Results: It is observed in our study, AUB is more common among the perimenopausal women (50.9%) and also in multiparous women (86.7%). The commonest problem in our study population is heavy menstrual bleeding (HMB) (45.7%). In our study, the endometrial morphology assessed by TVS correlated statistically with the histopathology of endometrium (p<0.001). Hence, TVS, which is affordable and non–invasive can be used as the first line investigation of AUB, but histopathology of the endometrium always gives the confirmatory result.Conclusions: TVS can be used as the initial investigation for AUB, as it is affordable, non–invasive and has good acceptability by the patients. The endometrial morphology assessed by TVS correlated statistically with histopathological examination.
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