Diabetes in pregnancy: a practical guide for midwives

2019 ◽  
Vol 27 (7) ◽  
pp. 413-419
Author(s):  
Aarthi Surendran ◽  
Danielle Dixon ◽  
Martin Whyte
Keyword(s):  
Gestational Diabetes ◽  
Diabetes Management ◽  
Antenatal Clinic ◽  
Women Of Childbearing Age ◽  
Diabetes In Pregnancy ◽  
Childbearing Age ◽  
Pregnancy And Childbirth ◽  
Rising Incidence ◽  
Concise Guide ◽  
In Pregnancy

Diabetes is a growing concern. With the rising incidence of obesity in the younger people, the incidence of diabetes has also increased. This has resulted in more women of childbearing age attending antenatal clinic with a diagnosis of either pre-existing or gestational diabetes. Management of these women is vital to avoid complications in both the mother and the child during pregnancy and childbirth. This article aims to provide a concise guide to the management of diabetes in pregnancy for midwives, who are often the first point of contact for these women.

scholarly journals Evaluation of “Diabetes in Pregnancy Study Group of India” (DIPSI) Criterion as a Diagnostic Test for Gestational Diabetes Mellitus

2021 ◽  
Vol 11 (6) ◽  
pp. 1-5
Author(s):  
Aradhana Singh ◽  
Raj K Singh ◽  
Vani Aditya
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Antenatal Clinic ◽  
Oral Glucose ◽  
Study Group ◽  
Diabetes In Pregnancy ◽  
Inclusion Criteria ◽  
Capillary Glucose ◽  
In Pregnancy

Introduction: In view of the alarmingly increasing incidence of Gestational Diabetes Mellitus (GDM), worldwide, as well as in India, a consensus to bring about standardization for diagnosis of GDM is needed. Internationally, the WHO 2013 criteria is being widely used, while (Diabetes In Pregnancy Study Group of India) DIPSI non fasting criteria is popularly used in India. There still remains many missed cases of GDM in India, which is a cause of concern. This study was done to compare the DIPSI non fasting, with WHO 2013 criteria for diagnosis of GDM. Methods: this cross-sectional study included 530 pregnant women, attending antenatal clinic of a tertiary care center, of North India, from Feb. 2018 to March 2019 and fulfilling inclusion criteria. All women attending antenatal clinic, during the study period, were subjected to capillary glucose evaluation, 2 hours after 75g oral glucose load, irrespective of the timing of last meal (DIPSI), as part of routine antenatal checkup. After 7 days, only those 530 women, who turned up in fasting state, and fulfilled inclusion criteria, were enrolled in the study and subjected to fasting 75g, oral glucose tolerance test (OGTT) (WHO 2013). Accuracy of DIPSI test was compared, to the fasting WHO 2013 criteria. Capillary glucose was measured using regular, well calibrated, point of care, “Optium Free Style” glucometer. Results: Out of 107 women diagnosed to have GDM by WHO 2013 criteria, only 89 were diagnosed by the DIPSI criteria. DIPSI had a low sensitivity (83.18%) when compared to the WHO 2013 criteria, Conclusion: This study showed that when non fasting DIPSI criteria was used as diagnostic criteria, 10.58% women with GDM, missed the diagnosis. Considering the adverse maternal and perinatal outcome of GDM, implication of missed diagnosis would be grave, especially in a developing country, like India. Hence, use of DIPSI criteria for diagnosing GDM should be reconsidered. Key words: GDM, DIPSI, OGTT, Diabetes in Pregnancy.

Appreciation of the importance of pregravid preparation and reproductive attitudes of women of childbearing age in the city of Omsk

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 48-52
Author(s):  
E N Kravchenko ◽  
R A Morgunov
Keyword(s):  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Pregnancy And Childbirth ◽  
Perinatal Center ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Complicated Pregnancy ◽  
The Relationship ◽  
The City

The aim of the study. Assess the importance of pregravid preparation and outcomes of pregnancy and childbirth, depending on the reproductive attitudes of women in the city of Omsk. Materials and methods. The study included 92 women who were divided into groups: group A (n=43) - women whose pregnancy was planned; group B (n=49) - women whose pregnancy occurred accidentally. Each group was divided into subgroups depending on age: from 18 to 30 and from 31 to 49 years. For each patient included in the study, a specially designed map was filled out. These patients were interviewed at the City Clinical Perinatal Center. Results. Comparative analysis revealed the relationship between the reproductive settings of women of childbearing age and the peculiarity of the course of pregnancy and childbirth in these patients. Summary. The majority of women of fertile age are married: in subgroup AA - 25 (96.2%), AB - 13 (76.5%), BA - 25 (92.6%), BB - 20 (91.0%). The predominant number of women of fertile age have one or more abortions: in subgroup AA - 12 (46.2%), AB - 6 (35.3%), in subgroups of comparison BA - 8 (29.6%), BB - 6 (27.3%). More than half of the women of fertile age surveyed have a history of untreated cervical pathology (from 40.8% to 64.7%). The course of pregnancy in women planning pregnancy in most cases proceeded without complications: in subgroup AA - 13 (50.0%), AB - 11 (64.7%). The most common cause of complicated pregnancy in women whose pregnancy occurred accidentally is the threat of spontaneous miscarriage: in subgroup BA - 15 (55.6%), BB - 16 (72.7%). The uncomplicated course of labor more often [subgroup AA - 19 (73.0%), AB - 12 (70.6%)] was observed in women whose pregnancy was planned and they were motivated to give birth to a healthy child.

scholarly journals Assessment of Health Seeking Behavior of Gestational Diabetes in Pregnancy among Elderly Primi Mother

2021 ◽  
pp. 261-267
Author(s):  
Prachi Dhale ◽  
Pragati Dhawale ◽  
Amrin Dosani ◽  
Gaurav Dongare ◽  
Bali Thool
Keyword(s):  
Blood Glucose ◽  
Gestational Diabetes ◽  
Adverse Pregnancy Outcome ◽  
The Elderly ◽  
Diabetes In Pregnancy ◽  
Health Seeking ◽  
Health Seeking Behavior ◽  
Increased Risk ◽  
Seeking Behavior ◽  
In Pregnancy

Introduction: Gestational diabetes mellitus (GDM) is diagnosed by elevated blood glucose in pregnancy though the definition has changed repeatedly since its first description in the 1960’s. The most frequently reported perinatal consequence of GDM is macrosomia (usually defined as a neonate weighing over 4 kg) which can increase the risk of caesarean section and shoulder dystocia. For the mother, there are also potential longer-term consequences including an increased risk of type 2 diabetes post-pregnancy and/or in later life. The investigators of a large international Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study aimed to identify a cut-point in the continuum to decide the blood glucose level (BGL) thresholds that should be used to define GDM. Objective: To assess the incidence rate of gestational diabetes in pregnancy among the elderly primi mother. To assess the health seeking behavior of gestational diabetes in elderlyprimimothers.  To associate the demographic variables of gestational diabetes in elderly primi mothers. Materials and Methods: A Descriptive research study was to assess the incidence and Health seeking behavior of gestational diabetes in pregnancy among the elderly primi mother. The target population for the study includes all antenatal women (12-36 weeks of gestation) who attend the antenatal clinics of AVBRH Out Patient Department. Sample consists of sub set of units that compose accessible population. In this study sample size was 100 elderly primi mother of selected area of community of Wardha. A tool is an instrument or equipment used for collection of data. A blue print was prepared prior to the construction of knowledge questionnaire based on which items were developed. Results: A finding shows that (41%) were having good, (40%) were having very good, (17%) were having average and (2%) were having excellent knowledge score. The minimum score was 05 and maximum score was 14, the mean score for the test was 8.93 ± 2.23 and mean percentage of knowledge was 59.54%. There was no significant association in relation to age, education, occupation, No.of gravida, income etc.

Diabetes in pregnancy

2020 ◽  
pp. 2627-2637
Author(s):  
Bryony Jones ◽  
Anne Dornhorst
Keyword(s):  
Gestational Diabetes ◽  
Post Partum ◽  
Insulin Dose ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Diabetes In Pregnancy ◽  
In Pregnancy

Diabetes in pregnancy is predominantly either pre-existing type 1 or type 2 diabetes mellitus, or gestational diabetes, the latter defined as diabetes or glucose intolerance first diagnosed during the pregnancy. Gestational diabetes usually arises in the late second trimester and is common, affecting from 2–6% to 15–20% of pregnant women depending on diagnostic criteria and country of origin. Gestational diabetes is most commonly diagnosed on the basis of an oral glucose tolerance test performed at 24–28 weeks’ gestation by a plasma glucose at 0 minutes of more than 5.1 (or >5.6, depending on the authority) mmol/L, or at 120 minutes of more than 8.5 (or >7.8) mmol/L. The effect of pregnancy on maternal glycaemic control ceases very quickly post-partum, hence women with pre-existing diabetes taking insulin should immediately revert to their pre-pregnancy regimen after birth, but with a lower insulin dose.

Endocrine and autoimmune disorders

2016 ◽  
Author(s):  
Mirjana Kendrisic ◽  
Borislava Pujic
Keyword(s):  
Gestational Diabetes ◽  
Autoimmune Diseases ◽  
Pregnancy Outcome ◽  
Intensive Therapy ◽  
Anaesthetic Management ◽  
Autoimmune Disorders ◽  
Endocrine Disorders ◽  
Childbearing Age ◽  
Long Term Outcome ◽  
In Pregnancy

Advanced maternal age and increasing numbers of women of childbearing age with endocrine and autoimmune disorders have become the challenge for both anaesthetists and obstetricians. Genetic studies have provided new insight into underlying causes of endocrine disorders and prenatal prediction of inheritance. The expression of endocrine disease may influence the interpretation of diagnostic laboratory testing during pregnancy. Better understanding of the pathophysiological mechanisms enables new therapeutic approaches which can compromise pregnancy outcome. Although only a small number of drugs have been shown through clinical studies to be safe for use in pregnancy, intensive therapy for chronic disease is usually needed. Thus, anaesthetic management of women with endocrine disorders in pregnancy has become more complex. The most frequently encountered endocrine disorders during pregnancy include gestational diabetes mellitus and thyroid and adrenal disorders. Gestational diabetes has become increasingly common in pregnant women. Not only does it influence pregnancy outcome, but it also carries a risk for mother and offspring of developing type 2 diabetes later in life. Intensive glucose control may prevent maternal and fetal complications and improve long-term outcome. Pregnancy itself has been found to influence the course of autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus. However, autoimmune diseases may have adverse consequences for maternal, fetal, and neonatal health. There is a relative paucity of literature concerning anaesthetic management of autoimmune diseases. Early recognition and immediate treatment of the common complications have been the key elements to achieving the ultimate goal—good pregnancy outcome.

scholarly journals A longitudinal study of depression and gestational diabetes in pregnancy and the postpartum period

Diabetologia ◽  
2016 ◽  
Vol 59 (12) ◽  
pp. 2594-2602 ◽  
Author(s):  
Stefanie N. Hinkle ◽  
Germaine M. Buck Louis ◽  
Shristi Rawal ◽  
Yeyi Zhu ◽  
Paul S. Albert ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Gestational Diabetes ◽  
Postpartum Period ◽  
Diabetes In Pregnancy ◽  
In Pregnancy

scholarly journals Harmful cultural practices during perinatal period and associated factors among women of childbearing age in Southern Ethiopia: Community based cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254095
Author(s):  
Haimanot Abebe ◽  
Girma Alemayehu Beyene ◽  
Berhanu Semra Mulat
Keyword(s):  
Cultural Practices ◽  
Perinatal Period ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Community Based ◽  
Cross Sectional ◽  
Pregnancy And Childbirth ◽  
Harmful Cultural Practices

Introduction Although the maternal mortality ratio has decreased by 38% in the last decade, 810 women die from preventable causes related to pregnancy and childbirth every day, and two-thirds of maternal deaths occur in Sub-Saharan Africa alone. The lives of women and newborns before, during, and after childbirth can be saved by skilled care. The main factors that prevent women from receiving care during pregnancy and childbirth are harmful cultural practices. The aim of this study was to assess the level of harmful cultural practices during pregnancy, childbirth, and postnatal period, and associated factors among women of childbearing age in Southern Ethiopia. Methods A community-based cross-sectional study design was conducted in the Gurage zone, among representative sample of 422 women of reproductive age who had at least one history of childbirth. A simple random sampling technique was used to recruit participants. Data were collected by six experienced and trained data collectors using a pretested structured questionnaire with face to face interviews. Harmful cultural practices are assessed using 11 questions and those who participate in any one of them are considered as harmful cultural practices. Descriptive statistics were performed and the findings were presented in text and tables. Binary logistic regression was used to assess the association between each independent variable and outcome variable. Results Harmful cultural practices were found to be 71.4% [95%CI, 66.6–76.0]. The mean age of study participants was 27.6 (SD ± 5.4 years). Women with no formal education [AOR 3.79; 95%CI, 1.97–7.28], being a rural resident [AOR 4.41, 95%CI, 2.63–7.39], having had no antenatal care in the last pregnancy [AOR 2.62, 95%CI, 1.54–4.48], and pregnancy being attended by untrained attendants [AOR 2.67, 95%CI, 1.58–4.51] were significantly associated with harmful cultural practice during the perinatal period. Conclusion In this study we found that low maternal education, rural residence, lack of antenatal care and lack of trained birth attendant were independent risk factors associated with women employing harmful cultural practices during the perinatal period. Thus, strong multi-sectoral collaboration targeted at improving women’s educational status and primary health care workers should take up the active role of women’s health education on the importance of ANC visits to tackle harmful cultural practices.

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