Abnormal glucose challenge test in pregnancy: A study at tertiary care hospital

Abstract

The study was carried out to find out prevalence of abnormal glucose challenge test (GCT), using DIPSI guidelines by using venous as well as capillary glucometer test in pregnant women and also to study the risk factors along with feto-maternal outcome in diagnosed cases of abnormal GCT. Material & Methods:The present longitudinal study was conducted between June 2015 to May 2017 in GMCH, Aurangabad. A total of 700 pregnant women seeking antenatal care between 16-32 weeks gestation were enrolled for study. Selected women were subjected for 75gm oral glucose challenge test. Venous plasma glucose as well as capillary blood glucose values were estimated and compared. Abnormal glucose tolerance was diagnosed on the basis of 2 hour plasma glucose values more than 120 mg/dl. Prevalence of abnormal GCT & risk factors were studied. Women diagnosed and treated as per DIPSI guidelines and followed up for maternal and fetal outcome. Data collected was entered in Microsoft excel and analysed further using SPSS Software version 23 package. Results: Out of 700 antenatal women, 70 women were diagnosed as having abnormal GCT by venous plasma glucose. method. Abnormal GCT was seen in 10% of the screened participants. Statistically Significant association was found between abnormal GCT and age, BMI, gravidity, positive family history, history of previous fetal or early neonatal deaths. Sensitivity of capillary glucometer method was 100% and specificity was 99.68% when compared to venous laboratory method. Out of 70 cases diagnosed as abnormal GCT, 6 lost to follow up. In follow up of 64 women with abnormal GCT, 50 women were treated with medical nutritional therapy and 20 required MNT & insulin. 56 women delivered at term & 8 women had preterm delivery. Conclusion:In low resource settings where Venous plasma glucose is impossible, universal and timely screening of all pregnant women with 75 gm GCT with glucometer should be done to reduce adverse pregnancy outcome and for preventing type 2 DM. Creating awareness regarding risk factors and targeting this population for lifestyle modification is very essential in order to prevent fetal origin of adult onset diseases.