Outcome of Gestational Diabetes during Pregnancy and at Delivery

Abstract

Gestational diabetes (GDM) is a state of intolerance to glucose that initiates or is first diagnosed during gestation. About 1-14% of all pregnancies are complicated by GDM. The pregnancy-related morbidity and mortality in gestational diabetes is lower than in overt diabetes; however, if left untreated, it is significantly higher than in nondiabetic women. Treating GDM is important because appropriate treatment reduces side effects on the mother and newborn. GDM during pregnancy has a number of adverse short- and long-term consequences for both the mother and the fetus. Aim: To establish the relationship between gestational diabetes and complications related to pregnancy and childbirth. Study Design: A prospective cohort study. Place and Duration: The study was conducted at the Karachi Aga Khan University Hospital in the Department of Obstetrics and Gynecology from 22 November, 2018 to 22 May 2019, six months after the approval of the study. Methods: 130 patients, 65 patients in the GDM group and 65 patients in the non-GDM group were enrolled in the study. Demographic data were presented as standard deviation and mean as well as simple descriptive statistics, while qualitative variables as percentage and frequency. Chi-square test was applied for comparison of the incidence of complications related to pregnancy and childbirth. P<0.05 was considered statistically significant. Relative risk was calculated. Results: 130 total patients, including 65 patients in GDM group and 65 patients in non GDM group were included. Mean age in GDM and non GDM group was 29.27±2.79 years and 28.49±3.40 years. Outcome of pregnancy in GDM and non GDM group showed that 27 (41.5%) and 18 (27.7%) had pregnancy induced hypertension, 07 (10.8%) and 03 (4.6%) had pre-eclampsia, 29 (44.6%) and 07 (10.8%) had polyhydramnios, 04 (6.2%) and 02 (3.1%) had antepartum hemorrhage, 01 (1.5%) and 06 (9.2%) had premature rupture of membrane, 11 (16.9%) and 09 (13.8%) had preterm labour, 13 (20%) and 04 (6.2%) had urinary tract infection. Outcome of pregnancy in GDM and non GDM group showed 51 (78.5%) and 33 (50.8%) had induction of labour, 17 (26.2%) and 14 (21.5%) had low birth weight, 14 (51%) and 03 (4.6%) had macrosomia, 02 (3.1%) and 01 (1.5%) had birth injury and 10 (15.4%) and 11 (16.9%) had NICU admission. Conclusion: Gestational diabetes (GDM) is the utmost communal medicinal complication of pregnancy. It has negative consequences for the mother and the newborn baby. Maintaining glycemia in GDM decreases the morbidity of both baby and mother. Keywords: Gestational diabetes mellitus, delivery outcome, pregnancy outcome, maternal and fetal outcomes.

Postoperative Outcomes After Tympanoplasty for Active Versus Inactive Otitis Media Patients With Tympanic Membrane Perforation: A Systematic Review and Meta-Analysis

“…We assessed 221 full texts for eligibility as 18 were not able to be retrieved, of which we excluded 188 references. We included 33 studies (8–40) in the systematic review with full details available in a separate table [Supplementary Content 3, http://links.lww.com/MAO/B681], of which seven studies with similar study design (7–13) were included for the meta-analysis. A flowchart of the number of articles included or excluded at each stage is available in Figure 1.…”

“…Thirty-three studies (7–13,18–22,24–44) were included to analyze the outcomes and seven studies (7–13) were included for the meta-analysis. Twenty studies (60.6%) were undertaken in India, three studies (9.1%) in China, two studies (6.1%) each in Thailand and Bangladesh, and one study (3.0%) each in Korea, Nepal, Iraq, Italy, Egypt, and Pakistan.…”

“…Among the 33 studies (7–13,18–22,24–44) that met the inclusion criteria for this review, seven studies (7–13) have similar study design and reported the same outcome. Five of them (9–13) were pooled to assess the postoperative mean hearing gain consisting of 155 active otitis media patients receiving immediate tympanoplasty compared with 155 patients whose ears were dry (inactive) at point of surgery in Figure 3A as two studies (7,8) did not have sufficient data on postoperative hearing gain.…”

“…Twenty studies (60.6%) were undertaken in India, three studies (9.1%) in China, two studies (6.1%) each in Thailand and Bangladesh, and one study (3.0%) each in Korea, Nepal, Iraq, Italy, Egypt, and Pakistan. In terms of study design, 13 studies (11,19,20,(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) were randomized and 20 (7)(8)(9)(10)12,13,18,21,22,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) were nonrandomized. The inclusion and exclusion criteria of all studies are summarized in Supplementary Content 3, http://links.…”

“…Patient ages ranged from 15 to 60 years old. 23 studies recruited patients with dry ear status (11,(18)(19)(20)(21)(22)(24)(25)(26)(27)(28)(29)(31)(32)(33)35,36,(38)(39)(40)(42)(43)(44), three studies with wet ear status (30,34,37), and 7 studies with both dry and wet ear status (7)(8)(9)(10)12,13,41). Some studies only included microscopic myringoplasty (7-10, 12,13,18-21,24,26,31-33,35,37,40-42), some only endoscopic myringoplasty (27,28,30,34,38,44) and some included both types (11,19,20,(24)(25)(26)(27)(28)(29)…”