Does the Daily Plasma Glucose Variability Impact Maternal Weight Gain in Obese Pregnant Patients With Diabetes? [15M]

Abstract

INTRODUCTION: To evaluate the impact of a tertiary care vaginitis clinic with standardized protocols on health care utilization and prescription antifungal and antimicrobials for vaginitis-related concerns. METHODS: A retrospective analysis of electronic medical records of women with complaints of vaginitis attending a tertiary care vaginitis clinic (VC) in an integrated healthcare system. Women had vaginal microscopy, vaginal pH, an amine test, and vaginal mycology cultures at the index VC visit. Vulvovaginal candidiasis diagnoses required a positive mycology culture and bacterial vaginosis required 3 of 4 Amsel's criteria. Records were analyzed to compare the number of vaginitis-related encounters (clinic and telephone), fluconazole, and metronidazole (oral and vaginal) prescriptions in the 12 months before and the 12 months after the index VC visit. RESULTS:Out of 207 women identified over an 18 month time frame, age range 16-77 years (mean 38.5 years), 71.5% had at least 1 vaginitis-related encounter in the 12 months before the index VC visit; 47.3% in the 12 months after. The mean number of visits dropped from 2.06 to 0.98 (P,.0001, paired t test). The number of women with at least one fluconazole prescription and one metronidazole prescription decreased from 53.6% to 43.0% and 39.6%-18.8% respectively (P,.0001, paired t test).CONCLUSION: Attending a tertiary care vaginitis clinic resulted in a statistically significant reduction in vaginitis-related encounters and both fluconazole and metronidazole prescriptions for 12 months. A standardized vaginitis clinic may help reduce the burden of inappropriate diagnosis and treatment of vaginitis. INTRODUCTION:To examine the effect of maternal glucose variability on gestational weight gain in obese DM women according to the Institute of Medicine (IOM) guidelines and its impact on adverse maternal and neonatal outcomes.