Background Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. The aim of this study was to compare the prevalence of GDM using the World Health Organization (WHO) criteria and the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria in our population. We further compared the incidence of adverse maternal and neonatal outcomes in women diagnosed with GDM using these criteria and determined whether the IADPSG criteria is suitable in our population. Methods This randomized controlled trial was conducted at our antenatal clinic involving 520 patients from 1st February 2015 until 30th September 2017. They were randomized into the WHO and the IADPSG groups. All eligible women underwent a standard oral glucose tolerance test with 75 g glucose, their fasting and 2 h post prandial glucose levels were taken. The primary outcome was the prevalence of GDM. The secondary outcomes were the incidence of primary cesarean section, gestational hypertension or preeclampsia, preterm delivery <37 weeks, fetal macrosomia, neonatal hypoglycemia and shoulder dystocia or birth injury. Results The prevalence of GDM in both groups were similar (37.9% vs. 38.6%). GDM women in the WHO group had a significantly higher incidence of gestational hypertension or preeclampsia (p = 0.004) and neonatal hypoglycemia (p = 0.042). In contrast, GDM women in the IADPSG group had a significantly higher incidence of fetal macrosomia (p = 0.027) and cesarean section (p = 0.012). Conclusion The IADPSG diagnostic criteria for GDM may not be suitable for use in our population as it resulted in women being diagnosed later and being undertreated, thus leading to adverse maternal and neonatal outcomes.

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This study proved that the Vabra aspirator was not as effective as the Pipelle device in obtaining endometrial tissue for histological diagnosis. Despite its higher price per unit, the Pipelle device was a more cost-effective tool for outpatient endometrial assessment.

Background To evaluate the safety of Foley catheter cervical ripening and patients’ satisfaction in outpatient versus inpatient setting. Methods Sixty low risk women were randomized to outpatient (n = 25) and inpatient (n = 35) cervical ripening using Foley catheter. In both groups Foley catheter with 60 ml balloon was digitally inserted through the cervix with gentle traction applied. The outpatient group was discharged home after provision of verbal and written 24-hours contact information and instructions. The inpatient group was admitted to the ward. They were reassessed the next morning unless labor had begun or the catheter had dropped off. Results The demographic data between the two groups did not differ. The outpatient group has significant improvement in the Bishop score at second assessment (9.04 versus 7.89, p = 0.04), reduced duration of inpatient stay (41 versus 59, p < 0.001), able to sleep 5–6 hours (9 versus 1, p = 0.001), able to rest (23 versus 16, p = 0.001) and relax (23 versus 10, p < 0.001). Significantly, more women in the inpatient group had wished to be in the outpatient group (3 versus 21, p < 0.001). There was no difference in initial Bishop score, duration of oxytocin infusion and delivery within 24 hours. Both groups were similar in caesarean section rate, total blood loss, maternal and neonatal infection, primary postpartum hemorrhage, neonatal birthweight and cord pH. There was no incidence of uterine hyperstimulation, meconium aspiration syndrome and neonatal intensive care unit admission. Conclusion Outpatient Foley catheter cervical ripening had comparable efficacy and safety with inpatient for low-risk pregnancies and associated with better patient satisfaction. Trial registration: NCT04342741. It was retrospectively registered with ClinicalTrial.gov