Adverse Perinatal outcomes in Pre-Gestational and Gestational Diabetes Mellitus in a tertiary care hospital of Lahore, Pakistan
DOI:
https://doi.org/10.63075/6mvvdc36Abstract
Pre-Gestational and gestational diabetes mellitus is associated with adverse perinatal outcome in women. The only preventive measure is strict glycemic control. The current study aims to investigate and report the adverse perinatal outcomes in women with pre-gestational and gestational diabetes mellitus.
Methods:
The cross-sectional survey was done at Department of Obstetrics and Gynecology Unit-III, Sir Ganga Ram hospital, Lahore, Pakistan. Hundred women were included in the study. Fifty women had pre-gestational diabetes and another 50 had gestational diabetes. All patients were put on insulin therapy. Ante-natal assessment of fetal wellbeing was done via ultrasonography and cardiotocography by consultant obstetrician. The baby weight, APGAR score, amount of liquor, congenital abnormalities, blood sugar levels and duration of stay in the neonatal unit were also recorded.
Results:
The percentage of congenital malformations was 14% among pre-gestational diabetics and 2% in gestational diabetics. Among these 100 women the frequency of congenital malformations is more among patients with pre-gestational diabetes mellitus (PGDM) than gestational diabetes mellitus (GDM). Macrosomia occurred in 30% of gestational diabetics and 12% of pre-gestational diabetics. The percentage of development of macrosomia is more in patients with pre-gestational diabetes mellitus (PGDM) than gestational diabetes mellitus (GDM). The percentage of perinatal death among pre-gestational diabetics was 4% while no death was observed among gestational diabetics. There were no significant differences in the other parameters of perinatal outcome among pre-gestational and gestational diabetics.
Conclusion:
Diabetes mellitus, either pre-gestational or gestational, predicts adverse perinatal outcome. Strict glycemic control in peri-conception period and during pregnancy, and appropriate assessment of fetal wellbeing leads to outcome approaching that of non-diabetic mothers.
