scholarly journals Diabetes Mellitus Gestacional com ênfase nas Gestantes de Alto Risco / Gestational Diabetes Mellitus with an emphasis on High-Risk Pregnant Women

2021 ◽  
Vol 15 (58) ◽  
pp. 278-291
Author(s):  
Ana Luiza Almeida da Silva ◽  
Ana Paula Silveira Santos ◽  
Simei Gleide Silva Matos ◽  
Matheus Santos Marques

Resumo: Considerando o Diabetes Mellitus um problema de saúde pública e sendo um dos principais fatores de morbimortalidade no Brasil, torna-se relevante destacar o aumento de casos ocorridos do DMG em gestantes de alto risco. Esta pesquisa teve por objetivo: investigar o perfil clínico do diabetes mellitus gestacional (DMG) e como o mesmo pode levar a uma gravidez de alto risco, sua associação aos fatores de riscos e suas principais complicações. Quanto à metodologia é exclusivamente de caráter bibliográfico. Foi feita uma pesquisa de revisão bibliográfica, a qual utilizou fontes de internet, onde foram aplicados critérios de inclusão e exclusão, chegando a um total de 12 artigos selecionados. A partir desses artigos, a pesquisa verificou que os fatores de riscos associados ao DMG e suas complicações, fazem correlação com a gravidez de alto risco. Assim, se faz necessário o rastreamento e monitoramento, a prevenção, o diagnóstico e tratamento do DMG tanto para a mãe quanto para o feto. Logo é fundamental a atuação do farmacêutico na equipe multidisciplinar, pois contribui desde a gestão, aquisição até a dispensação eficiente dos medicamentos auxiliando de forma a reduzir os riscos, promovendo atenção, cuidado e uma saúde de qualidade às gestantes. Palavras Chave: Diabetes Mellitus. Diabetes Mellitus Gestacional. Gravidez de Alto Risco. Abstract: Considering Diabetes Mellitus a public health problem and one of the main morbidity and mortality factors in Brazil, it is relevant to highlight the increase in cases of GDM in high-risk pregnant women. This research aimed to: investigate the clinical profile of gestacional diabetes mellitus (GDM) and how it can lead to a high-risk pregnancy, its association with risk factors and its main complications. As for the methodology, it is exclusively bibliographic in nature. A bibliographic review research was carried out, using internet  sources,  where inclusion   and exclusion  criteria   were applied, reaching a total of  12 selected articles. From these articles, the research found that the risk factors associated with GDM and its complications are correlated with high-risk pregnancy. Thus, it is necessary the tracking and monitoring, prevention, diagnosis and treatment of GDM for both mother and fetus. Therefore, the role of the pharmacist in the multidisciplinary team is essential, as he contributes from the management, acquisition to the efficient dispensing of medicines, helping to reduce risks, promoting attention, care and quality health for pregnant women. Keywords: Diabetes Mellitus. Gestational Diabetes Mellitus. High-risk Pregnancy.

2009 ◽  
pp. 73-86
Author(s):  
Renata Tambelli ◽  
Manuela Errante

- In this review are discussed the main researches about high-risk pregnancy and, particularly, gestational diabetes mellitus (GDM). The results of these researches highlight that pregnant women with GDM are extremely vulnerable, anxious and worried. However there are not many clinical studies about the effect of GDM on the quality of mother-child relationship.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Carmelo Capula ◽  
Eusebio Chiefari ◽  
Anna Vero ◽  
Biagio Arcidiacono ◽  
Stefania Iiritano ◽  
...  

Recent Italian guidelines exclude women <35 years old, without risk factors for gestational diabetes mellitus (GDM), from screening for GDM. To determine the effectiveness of these measures with respect to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria, we evaluated 2,448 pregnant women retrospectively enrolled in Calabria, southern Italy. GDM was diagnosed following the IADPSG 2010 criteria. Among 538 women <35 years old, without risk factors, who would have not been tested according to the Italian guidelines, we diagnosed GDM in 171 (31.8%) pregnants (7.0% of total pregnants). Diagnosis was made at baseline (55.6%), 1 hour (39.8%), or 2 hours (4.7%) during OGTT. Despite of appropriate treatment, GDM represented a risk factor for cesarean section, polyhydramnios, increased birth weight, admission to neonatal intensive care units, and large for gestational age. These outcomes were similar to those observed in GDM women at high risk for GDM. In conclusion, Italian recommendations failed to identify 7.0% of women with GDM, when compared to IADPSG criteria. The risk for adverse hyperglycaemic-related outcomes is similar in low-risk and high-risk pregnants with GDM. To limit costs of GDM screening, our data suggest to restrict OGTT to two steps (baseline and 1 hour).


Author(s):  
Tulasa Basnet ◽  
Neelam Pradhan ◽  
Poonam Koirala ◽  
Kesang D. Bista

Background: Gestational Diabetes Mellitus (GDM) is associated with several adverse maternal and perinatal outcomes. Thus, screening for early detection of GDM and its treatment is important.Methods: This was hospital based descriptive study done over one year in department of Obstetrics and Gynecology, TUTH, Nepal. Six hundred ninety-seven women fulfilling the inclusion criteria were enrolled at 18-22 weeks of gestation. High risk factors were assessed and GCT was performed in women with risk factors during enrollment. Diagnostic OGTT was performed in women who screened positive (GCT ≥130mg/dl). Screen negative high-risk women were re-screened at 24-28 weeks. In women without known risk factors, GCT was performed at 24-28 weeks and OGTT was performed when screen positive. The diagnosis of GDM was made according to Carpenter and Coustan criteria.Results: Out of 697 enrolled women, 12 were excluded for various reasons and 685 women were analyzed. Women having risk of GDM were 28.9%. The prevalence of GDM was 2.92% and 2.48% with GCT cut off 130 mg/dl and 140 mg/dl respectively. Lowering the threshold to 130 mg/dl identified three extra cases (p=0.010). The prevalence among high risk group was 8.58% and 7.07% with the cut off value 130 mg/dl and 140 mg/dl respectively with three extra cases detected on taking cut off value 130 mg/dl (p=0.014). Among low risk women the prevalence of GDM was same i.e. 0.61% with both the cut off values.Conclusions: Lowering threshold of GCT to 130 mg/dl could identify significant percentage of extra cases of GDM especially in high risk women.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mayu Watanabe ◽  
Akihiro Katayama ◽  
Hidetoshi Kagawa ◽  
Daisuke Ogawa ◽  
Jun Wada

Poor maternal glycemic control increases maternal and fetal risk for adverse outcomes, and strict management of gestational diabetes mellitus (GDM) is recommended to prevent neonatal and maternal complications. However, risk factors for the requirement of antenatal insulin treatment (AIT) are not well-investigated in the pregnant women with GDM. We enrolled 37 pregnant women with GDM and investigated the risk for AIT by comparing the patients with AIT (AIT group;n=10) and without insulin therapy (Diet group;n=27). The 1-h and 2-h plasma glucose levels and the number of abnormal values in 75 g OGTT were significantly higher in AIT group compared with Diet group. By logistic regression analysis, plasma glucose level at 1-h was significant predictor for AIT and the odds ratios were 1.115 (1.004–1.239) using forward selection method and 1.192 (1.006–1.413) using backward elimination method. There were no significant differences in obstetrical outcomes and neonatal complications. 1-h plasma glucose levels in 75 g OGTT are useful parameters in predicting the requirement for AIT in GDM. Both maternal and neonatal complications are comparable in GDM patients with and without insulin therapy.


Author(s):  
Deepti Khenwar ◽  
Juhi Agarwal ◽  
Sushruta Shriastava

Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during the present pregnancy. It affects 7% of all pregnancies worldwide and in India it ranges from 6 to 9% in rural and 12 to 21% in urban area. The aim of this study was to compare the DIPSI criteria with the two-step method (Carpenter and Couston criteria.) and to study merits and demerits of one step and two step tests for GDM.Methods: A total 400 pregnant women of gestational age between 24-28 weeks attending antenatal clinic at this study tertiary care center were enrolled in this study. 200 pregnant women were enrolled in each of the study group (Group I OGTT and Group II DIPSI).Results: In Group I (OGTT) screening 47 (23.5%) were tested positive. In Group II cases, screening test results were found positive among 44 (22%). Out of 95 high-risk pregnant women 38 (40%) were positive for GDM by OGTT and 34 (35.78%) were positive by DIPSI. Out of 305 non high-risk pregnant women, 9 (2.95%) were positive for GDM by OGTT and 10 (3.27%) were positive by DIPSI.Conclusions: Present study concludes that DIPSI is the test which can predict GDM in population comparable to another test like OGTT. Also, India’s major population reside in rural areas, ANC are mostly conducted by ANM, therefore screening test should be easy to perform and interpret.


2016 ◽  
Vol 06 (04) ◽  
pp. 269-276 ◽  
Author(s):  
Jean Baptsite Niyibizi ◽  
Florien Safari ◽  
Jean Bosco Ahishakiye ◽  
Jean Bosco Habimana ◽  
Herbert Mapira ◽  
...  

JMS SKIMS ◽  
2014 ◽  
Vol 17 (1) ◽  
pp. 16-19
Author(s):  
Chandra Metgud

Objectives: 1. To know the incidence of high risk pregnancy. 2. To study the pregnancy outcome in Non-risk and High-risk antenatal mothers. Study Design: Longitudinal study. Setting: Shindolli Village of Belgaum District. Participants: All women in this village who were pregnant at the start of the study and who became pregnant during the study period. Sample Size: 125. Statistical Analysis: Percentages and Chi-square Test. Results: The incidence of High risk pregnancy was noted in 51(40.80%) pregnant women. The various risk factors noted were: primigravida 18 years, grand multipara, pre-eclampsia, bad obstetric history, severe anaemia etc. Among 125 pregnancy outcome, 69(93.24%) pregnant women in the non-risk group had good outcome compared to 34(66.67%) in the high risk group. The outcome of the pregnancy was significantly associated with presence of risk factors. Conclusion: The high-risk pregnancies are due to early marriages and child bearing at an early age. In rural areas early marriages are perpetuated by tradition, belief and family needs to reduce expenditures. A high percentage of anaemia in the pregnant women was due to the fact that, majority of them belonged to low social classes which affect their dietary intake and purchasing power adversely. Another common factor noted in rural area was grand multiparity, due to the need for male child. JMS 2014;17(1):16-19


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