Programmable Births in Gestational Diabetes Mellitus: Minimizing Risks — Improving Maternal and Perinatal Outcomes

2021 ◽  
Vol 76 (5S) ◽  
pp. 525-532
Author(s):  
Nadezhda M. Startseva ◽  
Viktor E. Radzinsky ◽  
Olga V. Papysheva ◽  
Larisa N. Esipova ◽  
Marina A. Oleneva ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Perinatal Outcomes ◽  
Neonatal Outcomes ◽  
Cesarean Sections ◽  
Maternal And Neonatal Outcomes

Background. Modernity is characterized by an avalanche-like increase in the frequency of gestational diabetes mellitus (in 45 times over the past 20 years). The main tasks of the work in the risk strategy of gestational diabetes mellitus are: prediction of pregnancy complications and the searchingh for new technologies for their delivery. To date, there are still very controversial questions about the timing and methods of delivery of patients with gestational diabetes mellitus. Due to the high incidence of unfavourable perinatal outcomes in gestational diabetes mellitus, the percentage of cesarean sections in some countries reaches 60%, which leads to maternal morbidity and a decrease in the reproductive health of the population. Aims is to improve of maternal and neonatal outcomes based of the rational choice of delivery technology in gestational diabetes mellitus. Methods. A retrospective analysis of delivery methods was performed in 9769 patients with gestational diabetes mellitus at full-term gestation. Results. The developed and implemented programmed delivery technique was an alternative to cesarean sections, it allowed to reduce the frequency of abdominal delivery, while improving maternal and neonatal outcomes. The frequency of cesarean sections in programmed delivery was 2 times lower than in the presented facilities and significantly lower than in the population (10.010.7%). In the programmed delivery group there was a significant reducing morbidity of hypoglycemia in newborns compared to planned caesarean section by 2 times and respiratory distress syndrome by 2.5 times (p 0.05). The indices of cerebral status impairment, birth traumatism corresponded to physiological childbirth and did not exceed the average population. Conclusions. The method of programmed delivery presented in this paper was one of the reserves for reducing the frequency of cesarean sections and allowed to personalize delivery in respiratory distress syndrome.

scholarly journals Prevalence and Pregnancy Outcome of Gestational Diabetes Mellitus Among Bangladeshi Urban Pregnant Women

2012 ◽  
Vol 13 (2) ◽  
pp. 147-151 ◽  
Author(s):  
MA Mannan ◽  
MH Rahman ◽  
I Ara ◽  
H Afroz
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Neonatal Jaundice ◽  
Distress Syndrome ◽  
Dhaka City

Objective: To assess the prevalence of gestational diabetes mellitus (GDM) among the pregnant women of Dhaka city and to find out the consequences or effects of GDM on pregnancy outcome. Materials and methods: This was a descriptive type of cross sectional study followed by cohort type of study, conducted in different hospitals in Dhaka city. Initially 960 pregnant women of 24th to 28th weeks were selected purposively; plasma glucose was measured at fasting and two hours after taking 75g oral glucose load. Modified method of Carpenter and Coustan criteria was followed to diagnose GDM. For each GDM case diagnosed, one non-GDM pregnant women was taken as control after matching age and parity. Both groups were followed up to 4 wks after delivery to find out maternal and neonatal mortality and morbidities. Results: Out of 960 pregnant women 72 were GDM positive (7.5%).There was no maternal mortality but morbidities like hydramnions (p<0.001)), pre-eclampsia (p<0.001)), urinary tract infection (p<0.05), puerperial sepsis (p<0.05)) and surgical interventions (p<0.001) were more prevalent in GDM compared to non-GDM groups. The prevalence of antipartum haemorrhage, post partum haemorrhage, and eclampsia did not vary between the groups. There was one still birth, one perinatal mortality (due to respiratory distress syndrome) and one congenital anomaly observed in neonates of GDM mothers. More pre-term (p<0.01), post-term (p<0.01), low birth weight (p<0.001) and macrosomic (p<0.001) babies were found among the babies of GDM mothers than non-GDM mothers. More babies also suffered from neonatal jaundice (p<0.05) and respiratory distress syndrome (p<0.05) in GDM groups than non GDM groups. Conclusion: The prevalence of GDM in urban Bangladeshi population is about 7.5%. Maternal morbidities like hydramnios, pre-eclampsia, infections and operative interventions were observed more in GDM mothers. Pre-term, post-term and LBW babies alone with perinatal morbidities like respiratory distress syndrome, macrosomia and neonatal jaundice were more common in babies of GDM mothers. DOI: http://dx.doi.org/10.3329/jom.v13i2.12749 J Medicine 2012; 13 : 147-151

Perinatal Maternal and Neonatal Outcomes in Women With Gestational Diabetes Mellitus According to Fetal Sex

2012 ◽  
Vol 9 (6) ◽  
pp. 411-417 ◽  
Author(s):  
Diana Tundidor ◽  
Apolonia García-Patterson ◽  
Miguel A. María ◽  
Justa Ubeda ◽  
Gemma Ginovart ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Neonatal Outcomes ◽  
Fetal Sex ◽  
Maternal And Neonatal Outcomes

scholarly journals Prevalence of Gestational Diabetes Mellitus, Maternal and Neonatal outcomes in a Peripheral Hospital in North India

2017 ◽  
Vol 5 (6) ◽  
pp. 2343 ◽  
Author(s):  
Naiyma Choudhary ◽  
Mohd Rasheed ◽  
Vivek Aggarwal
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Hypertension ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
North India ◽  
Peripheral Hospital ◽  
Medical Entity ◽  
Maternal And Neonatal Outcomes

Background: Gestational diabetes mellitus (GDM) is a well-known medical entity which should be diagnosed at the earliest to prevent adverse maternal and neonatal outcomes due to hyperglycemia.Methods: This study was done in patients attending antenatal OPD in a peripheral hospital in North India. A total of 569 patients diagnosed as GDM were included in the study out of 6321 who attended the antenatal clinic.Results: The prevalence of gestational diabetes mellitus was found to be 9%. Gestational hypertension was seen in 29.35% of patients. The percent of babies who were admitted to NICU was 29.35%.Conclusions: These results stress the need for early detection and treatment of GDM to prevent adverse outcomes.

scholarly journals Investigation the Effects of Metformin versus Insulin on Neonatal and Maternal Outcomes in Women with Gestational Diabetes Mellitus: A Randomized Clinical Trail

2016 ◽  
Vol 9 (4) ◽  
pp. 272 ◽  
Author(s):  
Mahin Najafian ◽  
Mojgan Barati ◽  
Sara Masihi ◽  
Ailin Fardipor
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Neonatal Outcomes ◽  
Neonatal Hypoglycemia ◽  
Singleton Pregnancy ◽  
Insulin Group ◽  
Metformin Group ◽  
Maternal And Neonatal Outcomes ◽  
The Mean

The aim of this study was to evaluate the effectiveness of metformin versus insulin in the glycemic control and to investigate the maternal and neonatal outcomes in in women with gestational diabetes mellitus. Pregnant women with gestational diabetes were randomized to either receive metformin (n=70) or insulin (n=70). Inclusion criteria were singleton pregnancy, following healthy diet and performing exercise for at least one week without satisfactory blood glucose level, no risk factor contributing to lactic acidosis, and no anatomic and/or chromosome anomalies. Two patients were excluded from the study due to lost to follow-up. The mean score of BMI and FBS after treatment was similar between two groups. But, the mean score of 2 hours blood sugar in insulin group (104.38±7.06 mg/dl) was significantly higher than metformin group (97.5±5.98 mg/dl) (P&lt;0.0001). The weight gain in metformin group was slightly lower than insulin group. (P=0.123). The proportion of neonatal hypoglycemia in insulin group was higher than metformin group (20 vs 3, P=0.002). Other neonatal outcomes such as IUGR, IUFD, fetal anomaly, polyhydramnios, macrosomia, oligohydramnios, and NICU stay did not differ significantly between two groups. In conclusion, metformin had compatible effect with insulin in decreasing adverse maternal and neonatal outcomes even in some parameters such as neonatal hypoglycemia it works better. Totally, metformin is safe and effectiveness in controlling the gestational diabetes mellitus.

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